You can custmize your Shipping Modules ...
Take item.php ... 2 files to customize:
/includes/modules/shipping/item.php
/includes/languages/english/modules/shipping/item.php
Copy to the files:
/includes/modules/shipping/usperitems.php
/includes/languages/english/modules/shipping/usperitems.php
Global replace item with usperitems ...
Global replace ITEM with USPERITEMS ...
WARNING: be aware free_shipping_items does not get touched ...
Next make one for Alaska, Hawaii, etc.
Copy to the files:
/includes/modules/shipping/usperitemsislands.php
/includes/languages/english/modules/shipping/usperitemsislands.php
Do basically the same on global replace but with usperitemsislands case sensative
On usperitems set Handling to 2.00 and Per Item charge to 2.00
This makes 1st product $4.00 and additional +$2.00
Make your Zones for these Shipping Modules ...
Once all done, you have your separate shipping modules for each area ...
NOTE: check MZMT and see if that doesn't have built in a per item charge like this as it would be easier and more flexible to use that if it does ...