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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Oklahoma rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $78 · 10th–90th $76$780%50%10th$78Professionalmedian $76 · 10th–90th $68$1100%20%10th90th$76$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$75.86
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93