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Integra Bilayer Matrix Wound Dressing

Pennsylvania 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?

$51.29

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $51.29 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $52.48 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$51.29$51.29 to $56.23
FacilityA hospital or hospital-owned outpatient department$52.48$51.29 to $126

How much rates vary

Facilitymedian $52 · 10th to 90th $51 to $447Professionalmedian $51 · 10th to 90th $51 to $126
$10.0$100.0$1.0K$10.0Kfacility $52professional $51

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
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$53.70
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$69.18
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$147.91
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$128.82
Typical High
$199.53
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$204.17
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$53.70
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$52.48
Typical High
$107.15
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$47.86
Typical High
$54.95
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$125.89
Typical High
$134.90

Where Pennsylvania 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.

Pennsylvania $51.29 · 44th 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.