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Integra Bilayer Matrix Wound Dressing

Nebraska 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?

$57.54

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $56.23 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$58.88$51.29 to $120
FacilityA hospital or hospital-owned outpatient department$56.23$51.29 to $57.54

How much rates vary

Facilitymedian $56 · 10th to 90th $49 to $224Professionalmedian $59 · 10th to 90th $50 to $126
$50$100$200facility $56professional $59

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
Facility
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Aetna
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$56.23
Typical High
$57.54
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$57.54
Typical High
$57.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$40.74
Median
$208.93
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$64.57
Typical High
$158.49
Medica
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$102.33
Typical High
$229.09
Medica
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$53.70
Typical High
$120.23
Midlands
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$64.57
Typical High
$190.55
Midlands
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$208.93
Typical High
$331.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$66.07
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Nebraska 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.

Nebraska· 45th of 51

$57.54

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.