go back

Integra Bilayer Matrix Wound Dressing

Alaska rates for HCPCS Q4104

Integra bilayer matrix wound dressing (BMWD), per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does Integra Bilayer Matrix Wound Dressing cost?

$95.50

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $95.50 for this service. The price depends on where it is billed: about $95.50 from a physician practice, and about $186 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$95.50$95.50 to $191
FacilityA hospital or hospital-owned outpatient department$186$112 to $316

How much rates vary

Facilitymedian $186 · 10th to 90th $58 to $550Professionalmedian $95 · 10th to 90th $66 to $309
$50$100$200$500$1Kfacility $186professional $95

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
$95.50
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$95.50
Typical High
$95.50
Cigna
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$316.23
Typical High
$933.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$51.29
Median
$95.50
Typical High
$134.90
Moda Health
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$407.38
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$112.20
Typical High
$177.83
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$81.28
Typical High
$97.72
Providence
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$302.00
Typical High
$933.25
Providence
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$66.07
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$346.74

Where Alaska sits

The same service costs 2.5 times more in Florida than in Indiana. 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.

Alaska· 24th of 51

$95.50

FL $126IN $51.29

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.