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
Cf Ewho W Jnts
Summit, NJ
See all hospitals reporting HCPCS L3764 →Price type
Overlook Medical Center’s median price of $1.1k is 24% above the median hospital's median price ($920), higher than 76% of the 1,050 hospitals reporting HCPCS L3764. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 18 payers, 50 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 | Anthem omc medicaid percent of total billed charges · bothfrom % of charges | $850 | $850 | — | — | — | $850 – $850 |
| 2 | Medicaid omc medicaid percent of total billed charges · bothfrom % of charges | $850 | $850 | — | — | — | $850 – $850 |
| 3 | Aetna omc aetna nnj prime fee schedule · both | $934 | $934 | — | — | — | $934 – $934 |
| 4 | Aetna omc aetna nnj prime fee schedule · outpatient | $934 | $934 | — | — | — | $934 – $934 |
| 5 | Tricare omc tricare-east (humana military) fee schedule · both | $996 | $996 | — | — | — | $996 – $996 |
| 6 | Tricare omc tricare-east (humana military) fee schedule · outpatient | $996 | $996 | — | — | — | $996 – $996 |
| 7 | Aetna omc aetna percent of total billed charges · bothfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 8 | Aetna omc aetna whole health percent of total billed charges · bothfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 9 | Aetna Better Health omc aetna better health percent of total billed charges · bothfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 10 | Aetna omc aetna ahs employee fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 11 | Aetna omc aetna ahs employee fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 12 | Aetna omc aetna medicare fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 13 | Aetna omc aetna medicare fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 14 | Anthem omc horizon braven fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 15 | Anthem omc horizon braven fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 16 | Blue Cross Blue Shield omc horizon braven fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 17 | Blue Cross Blue Shield omc horizon braven fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 18 | Cigna omc cigna medicare fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 19 | Cigna omc cigna medicare fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 20 | Highmark omc horizon braven fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 21 | Highmark omc horizon braven fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 22 | Tricare omc tricare contract fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | Tricare omc tricare contract fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 24 | Amerihealth Caritas omc amerihealth caritas fee schedule · both | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 25 | Amerihealth Caritas omc amerihealth caritas fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
Last updated: Apr 1, 2026
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