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Orbital Prosthesis, Provided by a Nonphysician

Massachusetts rates for HCPCS L8042

Orbital prosthesis, provided by a nonphysician

Rates data updated July 2026.

How much does Orbital Prosthesis, Provided by a Nonphysician cost?

$3,715

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $3,715 for this service. The price depends on where it is billed: about $3,548 from a physician practice, and about $5,248 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3,548$2,042 to $3,715
FacilityA hospital or hospital-owned outpatient department$5,248$3,236 to $6,166

How much rates vary

Facilitymedian $5,248 · 10th to 90th $1,862 to $7,413Professionalmedian $3,548 · 10th to 90th $1,862 to $5,623
$1.0$10.0$100.0$1.0K$10.0Kfacility $5,248professional $3,548

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,995.26
Typical High
$5,888.44
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$4,168.69
Typical High
$20,417.38
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$3,235.94
Typical High
$5,128.61
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$5,623.41
Typical High
$7,244.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$3,235.94
Typical High
$3,235.94
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$4,677.35
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$5,623.41
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$4,168.69
Typical High
$20,417.38
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$3,235.94
Typical High
$5,128.61
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,454.71
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$3,467.37
Typical High
$3,801.89

Where Massachusetts sits

The same service costs 5.8 times more in Hawaii than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Massachusetts $3,715 · 5th of 51
HI $10,000NE $1,738

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.