go back

Integra Bilayer Matrix Wound Dressing

South Dakota 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 South Dakota, July 2026.

Insurers have agreed to pay about $51.29 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 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$52.48$51.29 to $69.18
FacilityA hospital or hospital-owned outpatient department$51.29$51.29 to $81.28

How much rates vary

Facilitymedian $51 · 10th to 90th $51 to $91Professionalmedian $52 · 10th to 90th $51 to $100
$20.0$50.0$100.0$200.0facility $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
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$63.10
Avera
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$52.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$67.61
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$60.26
Typical High
$63.10
Medica
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$81.28
Typical High
$95.50
Medica
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$53.70
Typical High
$229.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$64.57
Typical High
$64.57
Midlands
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$169.82
Typical High
$204.17
Midlands
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$100.00
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$125.89
Typical High
$239.88
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29

Where South Dakota 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.

South Dakota $51.29 · 37th 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.