go back

Washington rates for HCPCS A4100

Nonsheet form skin substitute, FDA-cleared as a device, not otherwise specified (list in addition to primary procedure)

Facilitymedian $269 · 10th–90th $123$3630%10%10th90th$269Professionalmedian $107 · 10th–90th $69$2690%10%20%10th90th$107$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
$107.15
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$95.50
Typical High
$123.03
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$269.15
Typical High
$363.08
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$281.84
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$44.67
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$154.88
Typical High
$323.59
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$295.12