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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Tennessee 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 $708 · 10th–90th $126$7080%50%10th$708Professionalmedian $85 · 10th–90th $3$1200%10%20%10th90th$85$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
$72.44
Median
$125.89
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$83.18
Typical High
$120.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$275.42
Typical High
$275.42