L3905 — Wrist Hand Orthosis, Includes One Or More Nontorsion Joints, Elastic Bands, Turnbuckles, May Include Soft Interface, Straps, Custom Fabricated, Includes Fitting And Adjustment
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment (HCPCS L3905) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/L3905?code_type=HCPCS
MLA (9th ed.)
“Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment (HCPCS L3905) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/L3905?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment (HCPCS L3905) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/L3905?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $850–$1,513 (25th–75th percentile) across 1,601 hospitals · 3,045 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS L3905 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What this costs at this hospital
The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).
What hospitals actually negotiate
Measured
$850
$1,110 typical
$1,513
The middle 50% of negotiated facility rates for this procedure, measured across 1,601 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $1,110 |
| Likely subtotal | $1,110 |
Facility charge (no separate professional fee)
$1,110
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $850–$1,513.
- This is a drug/supply code billed by the facility; there is no separate professional fee to estimate — the figure above is the facility charge only.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Idemnity | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Idemnity | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Oxford | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Idemnity | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Local Value | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Idemnity | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Whole Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Local Value | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Whole Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Nj Health | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Local Value | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Whole Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Whole Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Geisinger | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Occunet | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Geisinger | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | First Mco | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Chn | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Local Plus | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Local Value | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Pnoa | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Brighton | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | First Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Geisinger | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Geisinger | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Geisinger | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Hst | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Qualcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Nj Health | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Three Rivers | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | United Community | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Healthcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Contigo Health | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Amerihealth | Local Value | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Phcs | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Healthcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Healthcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Nj Health | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Local Plus | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Amerihealth | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Cigna | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Oxford | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Nj Health | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Longevity Health | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Oxford | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Nj Health | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Multiplan | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Amerihealth | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Wellcare | Medicare | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Fidelis | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Better Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Prime Health | Ppo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Cigna | Hmo | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | United Healthcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Oxford | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Healthcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Local Plus | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Cigna | Local Plus | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | — | — | — | $4,191.00 | $419.10 | 2026-04-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Galaxy | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Cigna | Local Plus | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Oxford | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Whole Health | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Naphcare | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Idemnity | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $4,191.00 | $419.10 | 2026-07-15 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.