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Integra Bilayer Matrix Wound Dressing

Oregon 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 Oregon, 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 $52.48 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$70.79 to $141
FacilityA hospital or hospital-owned outpatient department$52.48$48.98 to $117

How much rates vary

Facilitymedian $52 · 10th to 90th $49 to $234Professionalmedian $126 · 10th to 90th $51 to $219
$50$100$200facility $52professional $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
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Cigna
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$223.87
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$275.42
Typical High
$346.74
Moda Health
Setting
Facility
Modifier
None
Typical Low
$13.80
Median
$72.44
Typical High
$89.13
Moda Health
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$141.25
Typical High
$275.42
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$51.29
Typical High
$83.18
Providence
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$208.93
Typical High
$288.40
Providence
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$125.89
Typical High
$147.91
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$204.17
Typical High
$218.78
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Oregon 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.

Oregon· 8th 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.