Integra dermal matrix skin substitute at Progress West Hospital

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Dsg 52021 5cm X 5cm Mtrx Wound Acl per Sq Cm

O'Fallon, MO

See all hospitals reporting HCPCS Q4108 →

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How this price compares nationally

Progress West Hospital’s median price of $200 is 52% above the median hospital's median price ($132), higher than 71% of the 1,386 hospitals reporting HCPCS Q4108. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4108 at Progress West Hospital

Negotiated rates from the hospital’s own file: 12 payers, 28 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	Cigna bjc hb cigna local plus community fee schedule · both	$64	$64	—	—	—	$64 – $64
2	Cigna bjc hb cigna hmo/ppo community fee schedule · both	$72	$72	—	—	—	$72 – $72
3	Cigna bjc hb cigna special community fee schedule · both	$72	$72	—	—	—	$72 – $72
4	Aetna bjc hb medicare advantra pwc other · both	$125	$125	—	—	—	$125 – $125
5	Aetna bjc hb medicare gold advantage pwc other · both	$125	$125	—	—	—	$125 – $125
6	Blue Cross Blue Shield bjc hb medicare anthem advantage pwc other · both	$125	$125	—	—	—	$125 – $125
7	Humana bjc hb medicare humana pwc other · both	$125	$125	—	—	—	$125 – $125
8	UnitedHealthcare bjc hb medicare uhc pwc other · both	$125	$125	—	—	—	$125 – $125
9	Devoted bjc hb medicare devoted pwc other · both	$131	$131	—	—	—	$131 – $131
10	Medica bjc hb medicare wellfirst pwc other · both	$131	$131	—	—	—	$131 – $131
11	Humana bjc hb humana choicecare community percent of total billed charges · bothfrom % of charges	$165	$165	—	—	—	$165 – $165
12	Blue Cross Blue Shield bjc hb anthem choice community percent of total billed charges · bothfrom % of charges	$200	$200	—	—	—	$200 – $200
13	Blue Cross Blue Shield bjc hb anthem access community percent of total billed charges · bothfrom % of charges	$203	$203	—	—	—	$203 – $203
14	UnitedHealthcare bjc hb united health care community fee schedule · both	$210	$210	—	—	—	$210 – $210
15	Aetna bjc hb aetna national percent of total billed charges · bothfrom % of charges	$228	$228	—	—	—	$228 – $228
16	Aetna bjc hb first health percent of total billed charges · bothfrom % of charges	$228	$228	—	—	—	$228 – $228
17	First Health bjc hb first health percent of total billed charges · bothfrom % of charges	$228	$228	—	—	—	$228 – $228
18	UnitedHealthcare bjc hb first health percent of total billed charges · bothfrom % of charges	$228	$228	—	—	—	$228 – $228
19	Aetna bjc hb group health plan ppo select percent of total billed charges · bothfrom % of charges	$230	$230	—	—	—	$230 – $230
20	Beechstreet bjc hb multiplan percent of total billed charges · bothfrom % of charges	$230	$230	—	—	—	$230 – $230
21	MultiPlan bjc hb multiplan percent of total billed charges · bothfrom % of charges	$230	$230	—	—	—	$230 – $230
22	Phcs bjc hb phcs community percent of total billed charges · bothfrom % of charges	$230	$230	—	—	—	$230 – $230
23	Medica bjc hb wellfirst first health community percent of total billed charges · bothfrom % of charges	$246	$246	—	—	—	$246 – $246
24	Phcs bjc hb wellfirst first health community percent of total billed charges · bothfrom % of charges	$246	$246	—	—	—	$246 – $246
25	Blue Cross Blue Shield bjc hb anthem alliance epo percent of total billed charges · bothfrom % of charges	$261	$261	—	—	—	$261 – $261

Page 1 of 2 · 28 rates

Last updated: Dec 15, 2025

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