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Integra Bilayer Matrix Wound Dressing

New York 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?

$52.48

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $52.48 for this service. The price depends on where it is billed: about $52.48 from a physician practice, and about $51.29 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 9 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$52.48$50.12 to $67.61
FacilityA hospital or hospital-owned outpatient department$51.29$51.29 to $126

How much rates vary

Facilitymedian $51 · 10th to 90th $51 to $182Professionalmedian $52 · 10th to 90th $49 to $120
$10.0$100.0$1.0K$10.0Kfacility $51professional $52

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
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$53.70
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$63.10
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$165.96
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$151.36
Typical High
$338.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$162.18
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$52.48
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$52.48
Typical High
$52.48
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$58.88
Typical High
$63.10
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$51.29
Typical High
$125.89
Univera
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$56.23
Univera
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$52.48
Typical High
$52.48

Where New York 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.

New York $52.48 · 23rd 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.