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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 July 2026.

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

$102

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $102 for this service. The price depends on where it is billed: about $102 from a physician practice, and about $8.13 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$102$87.10 to $182
FacilityA hospital or hospital-owned outpatient department$8.13$5.13 to $195

How much rates vary

Facilitymedian $8 · 10th to 90th $3 to $245Professionalmedian $102 · 10th to 90th $3 to $182
$5$10$20$50$100$200facility $8professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$87.10
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$181.97
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$5.13
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$263.03
Typical High
$275.42

Where South Dakota sits

The same service costs 2.6 times more in Alaska than in Mississippi. 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· 18th of 51

$102

AK $182MS $69.18

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.