Oasis wound matrix for burns at Overlook Medical Center

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

Sup Rev Cd 636 Hcpcs Q4103

Summit, NJ

See all hospitals reporting HCPCS Q4103 →

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Pricing by billing methodology

Price type

How this price compares nationally

Overlook Medical Center’s median price of $742 is 1044% above the median hospital's median price ($65), higher than 97% of the 1,183 hospitals reporting HCPCS Q4103. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4103 at Overlook Medical Center

Negotiated rates from the hospital’s own file: 17 payers, 33 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 omc cigna local plus fee schedule · both	$8	$8	—	—	—	$8 – $8
2	Cigna omc cigna oap fee schedule · both	$10	$10	—	—	—	$10 – $10
3	Cigna omc cigna ppo fee schedule · both	$11	$11	—	—	—	$11 – $11
4	Blue Cross Blue Shield omc horizon commercial fee schedule · both	$34	$34	—	—	—	$34 – $34
5	Blue Cross Blue Shield omc horizon omnia fee schedule · both	$34	$34	—	—	—	$34 – $34
6	Anthem omc medicaid percent of total billed charges · bothfrom % of charges	$366	$410	$247	60%	—	$132 – $731
7	Medicaid omc medicaid percent of total billed charges · bothfrom % of charges	$366	$410	$247	60%	—	$132 – $731
8	Aetna Better Health omc aetna better health percent of total billed charges · bothfrom % of charges	$439	$492	$296	60%	—	$158 – $878
9	Humana omc qualcare percent of total billed charges · bothfrom % of charges	$742	$831	$501	60%	—	$267 – $1.5k
10	Oscar omc qualcare percent of total billed charges · bothfrom % of charges	$742	$831	$501	60%	—	$267 – $1.5k
11	Kaiser phcs primary network percent of total billed charges · bothfrom % of charges	$1.2k	$1.3k	$787	60%	—	$420 – $2.3k
12	Phcs phcs primary network percent of total billed charges · bothfrom % of charges	$1.2k	$1.3k	$787	60%	—	$420 – $2.3k
13	Aetna omc aetna percent of total billed charges · bothfrom % of charges	$1.3k	$1.4k	$859	60%	—	$458 – $2.5k
14	Aetna omc aetna whole health percent of total billed charges · bothfrom % of charges	$1.3k	$1.4k	$859	60%	—	$458 – $2.5k
15	Anthem omc empire bcbsny hmo ppo percent of total billed charges · bothfrom % of charges	$1.3k	$1.4k	$859	60%	—	$458 – $2.5k
16	First Health first health percent of total billed charges · bothfrom % of charges	$1.4k	$1.5k	$930	60%	—	$496 – $2.8k
17	MultiPlan multiplan complementary network percent of total billed charges · bothfrom % of charges	$1.5k	$1.7k	$1.0k	60%	—	$534 – $3.0k
18	Anthem omc empire bcbsny indemn percent of total billed charges · bothfrom % of charges	$1.8k	$2.0k	$1.2k	60%	—	$649 – $3.6k
19	Aetna omc aetna ahs employee other · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
20	Aetna omc aetna medicare fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
21	Aetna omc aetna nnj prime other · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
22	Ambetter omc ambetter wellcare of nj other · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
23	Anthem omc horizon braven other · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
24	Blue Cross Blue Shield omc horizon braven other · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
25	Cigna omc cigna medicare fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k

Page 1 of 2 · 33 rates

Last updated: Apr 1, 2026

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See Oasis wound matrix for burns pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.