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Orbital Prosthesis, Provided by a Nonphysician

Montana 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?

$3,467

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $3,467 for this service. The price depends on where it is billed: about $3,311 from a physician practice, and about $3,715 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 5 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$3,311$2,138 to $3,715
FacilityA hospital or hospital-owned outpatient department$3,715$3,020 to $3,981

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,512 to $4,677Professionalmedian $3,311 · 10th to 90th $1,175 to $7,244
$100$200$500$1K$2K$5K$10Kfacility $3,715professional $3,311

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
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$3,311.31
Typical High
$18,197.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,981.07
Typical High
$3,981.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$3,981.07
Typical High
$3,981.07
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$3,715.35
Typical High
$7,244.36
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$3,715.35
Typical High
$7,244.36
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,548.13
Typical High
$5,623.41
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$3,090.30
Typical High
$3,981.07
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,398.83
Typical High
$2,884.03
United
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,819.70
Typical High
$2,754.23

Where Montana sits

The same service costs 5.8 times more in Hawaii than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 8th of 51

$3,467

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.