CPT 21077
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Impression and custom preparation; orbital prosthesis
Prices here combine facility and professional fees. See them separately →Experimental
Low
$1
Average
$8.4k
Median
$6.7k
High
$665.2k
Showing only prices reported under the case rate methodology. Choose another in the filter below to change the chart. 786 hospitals; the 90th percentile is 4.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
Filter by billing methodology
Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Lewisgale Hospital Montgomery CHRISTIANSBURG, VA | $7.3k | $8.4k | $5.3k | 64% | — | $2.0k – $20.2k |
| 2 | USA Health University Hospital Mobile, AL | $2.2k | $2.3k | $218 | 9% | — | $2.1k – $3.0k |
| 3 | Fairview Health Services Edina, MN | $4.5k | $4.5k | $1.8k | 40% | — | $1.6k – $7.6k |
| 4 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI | $12.5k | $12.7k | $1.7k | 13% | — | $9.6k – $16.4k |
| 5 | Hca Florida West Hospital PENSACOLA, FL | $15.1k | $18.7k | $13.2k | 71% | — | $1.9k – $40.7k |
| 6 | Mayo Regional Hospital Dover Foxcroft, ME | $2.3k | $10.1k | $12.4k | 122% | — | $2.3k – $32.0k |
| 7 | Deaconess Hospital, Inc Newburgh, IN | $5.8k | $8.3k | $3.1k | 37% | — | $5.5k – $13.8k |
| 8 | Methodist Hospital Hill Country Fredericksburg, TX | $7.8k | $7.0k | $2.9k | 41% | — | $948 – $10.9k |
| 9 | Hca Healthone Northeast Er THORNTON, CO | $6.7k | $7.6k | $3.2k | 42% | — | $1.2k – $11.9k |
| 10 | Baylor Scott & White Medical Center - Lakeway Lakeway, TX | $6.3k | $6.6k | $1.1k | 16% | — | $5.4k – $8.0k |
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