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Integra Bilayer Matrix Wound Dressing

New Jersey 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?

$126

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $257 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$51.29 to $138
FacilityA hospital or hospital-owned outpatient department$257$145 to $13,490

How much rates vary

Facilitymedian $257 · 10th to 90th $51 to $21,380Professionalmedian $126 · 10th to 90th $51 to $148
$100$500$2K$10Kfacility $257professional $126

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
Cigna
Setting
Facility
Modifier
None
Typical Low
$77.62
Median
$165.96
Typical High
$257.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$69.18
Typical High
$162.18
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$13,489.63
Typical High
$26,915.35
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$147.91
Typical High
$147.91
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$141.25

Where New Jersey 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.

New Jersey· 10th of 51

$126

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.