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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

South Dakota 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 October 2026.

How much does Nonsheet Skin Substitute, FDA-Cleared, Unclassified cost?

$148

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $5.13 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$3.02 to $182
FacilityA hospital or hospital-owned outpatient department$5.13$5.13 to $112

How much rates vary

Facilitymedian $5 · 10th to 90th $5 to $245Professionalmedian $148 · 10th to 90th $3 to $182
$5$10$20$50$100$200facility $5professional $148

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.51
Median
$1.51
Typical High
$1.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$245.47
Cigna
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$181.97
Medica
Setting
Facility
Modifier
None
Typical Low
$5.13
Median
$5.13
Typical High
$5.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$281.84

Where South Dakota sits

The same service costs 83.2 times more in North Dakota than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 9th of 51

$148

ND $251KS $3.02

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.