go back

Oregon rates for HCPCS A4100

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $175.00 / $194.25
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400,000.00 / $2,400,000.00 / $2,400,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,250,000.00 / $2,250,000.00 / $2,400,000.00