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Integra Bilayer Matrix Wound Dressing

Arizona 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?

$53.70

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $89.13 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 5 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$53.70$51.29 to $93.33
FacilityA hospital or hospital-owned outpatient department$89.13$58.88 to $141

How much rates vary

Facilitymedian $89 · 10th to 90th $47 to $224Professionalmedian $54 · 10th to 90th $51 to $126
$20.0$50.0$100.0$200.0$500.0facility $89professional $54

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
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$58.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$79.43
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$58.88
Typical High
$102.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$125.89
Typical High
$125.89

Where Arizona 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.

Arizona $53.70 · 16th 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.