Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
BILAYER COLLAGEN WOUND MATRIX 5X5CM ( IMPLANT QTY = 25CM ) -- # BMW2021
Utica, NY
See all hospitals reporting HCPCS Q4104 →Price type
MVHS, Inc.’s median price of $667 is 391% above the median hospital's median price ($136), higher than 74% of the 1,723 hospitals reporting HCPCS Q4104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare uhc empire plan percent of total billed charges · bothfrom % of charges | $392 | $392 | — | — | — | $392 – $392 |
| 2 | Aetna aetna commercial percent of total billed charges · bothfrom % of charges | $584 | $584 | — | — | — | $584 – $584 |
| 3 | Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $667 | $667 | — | — | — | $667 – $667 |
| 4 | Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $667 | $667 | — | — | — | $667 – $667 |
| 5 | Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $667 | $667 | — | — | — | $667 – $667 |
| 6 | Excellus excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $667 | $667 | — | — | — | $667 – $667 |
| 7 | UnitedHealthcare uhc commercial percent of total billed charges · bothfrom % of charges | $715 | $715 | — | — | — | $715 – $715 |
| 8 | Humana humana hmo/pos percent of total billed charges · bothfrom % of charges | $735 | $735 | — | — | — | $735 – $735 |
Last updated: Aug 7, 2026
See Integra bone matrix wound dressing pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.