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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Wisconsin 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?

$155

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $355 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 8 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$151$75.86 to $288
FacilityA hospital or hospital-owned outpatient department$355$126 to $468

How much rates vary

Facilitymedian $355 · 10th to 90th $74 to $692Professionalmedian $151 · 10th to 90th $68 to $380
$5$10$20$50$100$200$500facility $355professional $151

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
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$74.13
Typical High
$109.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$263.03
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$416.87
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$181.97
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$85.11
Quartz
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$275.42
Typical High
$416.87
Quartz
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$691.83
Quartz
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$660.69
Security Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Security Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$239.88
Typical High
$398.11

Where Wisconsin 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.

Wisconsin· 2nd of 51

$155

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.