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Orbital Prosthesis, Provided by a Nonphysician

New York 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?

$2,291

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $2,291 for this service. The price depends on where it is billed: about $2,291 from a physician practice, and about $2,818 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 9 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$2,291$2,188 to $3,020
FacilityA hospital or hospital-owned outpatient department$2,818$1,995 to $4,571

How much rates vary

Facilitymedian $2,818 · 10th to 90th $1,622 to $6,761Professionalmedian $2,291 · 10th to 90th $1,778 to $6,026
$1.0$10.0$100.0$1.0K$10.0Kfacility $2,818professional $2,291

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
$1,995.26
Typical High
$5,011.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,995.26
Typical High
$2,884.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$4,570.88
Typical High
$9,120.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$2,290.87
Typical High
$6,456.54
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$3,548.13
Typical High
$3,715.35
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$3,548.13
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$3,235.94
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$7,413.10
Typical High
$17,378.01
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2,818.38
Median
$4,786.30
Typical High
$8,511.38
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,818.38
Typical High
$3,162.28
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50,118.72
Median
$53,703.18
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$4,365.16
Typical High
$5,128.61
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,398.83
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$2,884.03
Typical High
$7,413.10
Univera
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,691.53
Typical High
$2,691.53
Univera
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,691.53
Typical High
$2,818.38

Where New York 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.

New York $2,291 · 26th 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.