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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 July 2026.

How much does Integra Bilayer Matrix Wound Dressing cost?

$97.72

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $81.28 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 6 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$126$51.29 to $302
FacilityA hospital or hospital-owned outpatient department$81.28$51.29 to $112

How much rates vary

Facilitymedian $81 · 10th to 90th $32 to $178Professionalmedian $126 · 10th to 90th $51 to $407
$20.0$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $81professional $126

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$95.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$61.66
Typical High
$134.90
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$302.00
Typical High
$512.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$112.20
Typical High
$177.83
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$89.13
Typical High
$97.72
Providence
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$81.28
Typical High
$302.00
Providence
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$66.07
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$190.55
Typical High
$380.19

Where Alaska sits

The same service costs 2.0 times more in Minnesota than in Tennessee. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Alaska $97.72 · 2nd of 51
MN $102TN $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.