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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Oregon 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 $141 · 10th–90th $87$2630%10%20%10th90th$141Professionalmedian $123 · 10th–90th $69$3020%10%10th90th$123$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$117.49
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$95.50
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$323.59
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$141.25
Typical High
$257.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$251.19
Typical High
$316.23
Providence
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$144.54
Typical High
$269.15
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$102.33
Typical High
$102.33
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$302.00
Typical High
$363.08