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Orbital Prosthesis, Provided by a Nonphysician

New Jersey 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?

$2,089

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $2,089 for this service. The price depends on where it is billed: about $2,089 from a physician practice, and about $1,820 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$2,089$1,820 to $2,884
FacilityA hospital or hospital-owned outpatient department$1,820$1,622 to $3,236

How much rates vary

Facilitymedian $1,820 · 10th to 90th $1,122 to $4,571Professionalmedian $2,089 · 10th to 90th $1,660 to $2,951
$1K$2K$5K$10Kfacility $1,820professional $2,089

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
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,905.46
Typical High
$2,884.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$3,235.94
Typical High
$4,570.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$3,235.94
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$4,265.80
Typical High
$5,888.44
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$2,570.40
Typical High
$4,570.88
United
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$2,691.53
Typical High
$4,466.84

Where New Jersey 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.

New Jersey· 41st of 51

$2,089

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.