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Orbital Prosthesis, Provided by a Nonphysician

West Virginia 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?

$2,138

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $2,138 for this service. The price depends on where it is billed: about $2,138 from a physician practice, and about $1,995 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 4 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$2,138$1,995 to $2,138
FacilityA hospital or hospital-owned outpatient department$1,995$1,995 to $2,399

How much rates vary

Facilitymedian $1,995 · 10th to 90th $1,995 to $4,169Professionalmedian $2,138 · 10th to 90th $1,995 to $2,754
$1.0K$2.0K$5.0K$10.0K$20.0Kfacility $1,995professional $2,138

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
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$2,137.96
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$2,454.71
Typical High
$5,370.32
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$2,630.27
Typical High
$4,786.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$5,623.41
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$19,952.62
United
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,398.83
Typical High
$2,754.23
United
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,511.89
Typical High
$3,388.44

Where West Virginia 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.

West Virginia $2,138 · 36th 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.