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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Utah 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 Utah, July 2026.

Insurers have agreed to pay about $102 for this service. Most negotiated rates run $69.18 to $126.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $66 · 10th to 90th $66 to $66Professionalmedian $102 · 10th to 90th $66 to $182
$5$10$20$50$100$200facility $66professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$95.50
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$190.55
Select Health
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Select Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$204.17
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$208.93
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$239.88

Where Utah 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.

Utah· 17th 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.