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Integra Bilayer Matrix Wound Dressing

Indiana 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?

$51.29

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $51.29 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $209 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$51.29$51.29 to $58.88
FacilityA hospital or hospital-owned outpatient department$209$75.86 to $380

How much rates vary

Facilitymedian $209 · 10th to 90th $51 to $513Professionalmedian $51 · 10th to 90th $51 to $126
$20.0$100.0$500.0$2.0K$10.0Kfacility $209professional $51

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
$51.29
Median
$51.29
Typical High
$75.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$52.48
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$263.03
Typical High
$512.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$89.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$61.66
Typical High
$91.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$346.74
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$257.04
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Indiana 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.

Indiana $51.29 · 33rd 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.