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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 October 2026.

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

$155

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $355 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$155$102 to $324
FacilityA hospital or hospital-owned outpatient department$355$3.02 to $398

How much rates vary

Facilitymedian $355 · 10th to 90th $3 to $468Professionalmedian $155 · 10th to 90th $3 to $692
$5$10$20$50$100$200$500facility $355professional $155

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.51
Median
$1.51
Typical High
$1.51
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$288.40
Typical High
$831.76
Cigna
Setting
Facility
Modifier
None
Typical Low
$354.81
Median
$398.11
Typical High
$602.56
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$181.97
Medica
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Quartz
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$194.98
Typical High
$346.74
Quartz
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Security Health
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Security Health
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$173.78
Typical High
$331.13

Where Wisconsin sits

The same service costs 83.2 times more in North Dakota than in Kansas. 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· 8th of 51

$155

ND $251KS $3.02

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.