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Nonsheet Skin Substitute, FDA-Cleared, Unclassified

Wyoming 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 rates vary

Facilitymedian $126 · 10th to 90th $126 to $126Professionalmedian $126 · 10th to 90th $102 to $126
$5$10$20$50$100facility $126professional $126

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
$125.89
Median
$125.89
Typical High
$125.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$125.89
Typical High
$125.89
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$53.70
Median
$63.10
Typical High
$63.10
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$12.59
Median
$12.59
Typical High
$12.59
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$102.33