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Integra Bilayer Matrix Wound Dressing

Ohio 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?

$53.70

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $102 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 8 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$53.70$51.29 to $81.28
FacilityA hospital or hospital-owned outpatient department$102$51.29 to $240

How much rates vary

Facilitymedian $102 · 10th to 90th $51 to $316Professionalmedian $54 · 10th to 90th $51 to $126
$10.0$100.0$1.0Kfacility $102professional $54

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
$60.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$56.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$64.57
Typical High
$138.04
CareSource
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
CareSource
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$69.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$371.54
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$91.20
Typical High
$128.82
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$141.25
Typical High
$158.49
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$83.18
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$125.89

Where Ohio 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.

Ohio $53.70 · 14th 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.