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Integra Bilayer Matrix Wound Dressing

Hawaii 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?

$63.10

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $63.10 for this service. Most negotiated rates run $63.10 to $79.43.

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.

How much rates vary

Professionalmedian $63 · 10th to 90th $63 to $158
$100$200professional $63

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$56.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
HMSA
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$91.20
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$158.49
Typical High
$204.17
United
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$125.89
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$213.80

Where Hawaii 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.

Hawaii· 40th of 51

$63.10

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.