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Orbital Prosthesis, Provided by a Nonphysician

South Dakota 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 South Dakota, July 2026.

Insurers have agreed to pay about $3,715 for this service. The price depends on where it is billed: about $3,715 from a physician practice, and about $3,467 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 7 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$3,715$3,388 to $4,677
FacilityA hospital or hospital-owned outpatient department$3,467$2,754 to $4,169

How much rates vary

Facilitymedian $3,467 · 10th to 90th $2,291 to $7,413Professionalmedian $3,715 · 10th to 90th $2,884 to $5,888
$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $3,467professional $3,715

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$3,388.44
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$4,168.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$4,677.35
Typical High
$5,888.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,890.45
Typical High
$10,232.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$2,754.23
Typical High
$21,379.62
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$4,073.80
Typical High
$4,073.80
Midlands
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$3,388.44
Typical High
$6,918.31
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,801.89
Typical High
$5,011.87
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,398.83
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$2,691.53
Typical High
$4,570.88
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35

Where South Dakota 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.

South Dakota $3,715 · 4th 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.