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Drainage Of An Infected Tear Sac

West Virginia rates for HCPCS 68420

A small incision made to drain infected fluid or pus from the tear sac, a small reservoir at the inner corner of the eyelids where tears collect before draining into the nose. This is used to treat an infection or abscess of that structure, relieving pain and swelling.

Rates data updated July 2026.

How much does Drainage Of An Infected Tear Sac cost?

$275

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $257 from a physician practice, and about $331 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$257$178 to $355
FacilityA hospital or hospital-owned outpatient department$331$166 to $331

How much rates vary

Facilitymedian $331 · 10th to 90th $166 to $1,230Professionalmedian $257 · 10th to 90th $155 to $427
$50$100$200$500$1K$2K$5Kfacility $331professional $257

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
$165.96
Median
$331.13
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$251.19
Typical High
$407.38
CareSource
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$204.17
CareSource
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$245.47
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$316.23
Typical High
$3,162.28
United
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$2,089.30
Typical High
$6,606.93
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$257.04
Typical High
$478.63

Where West Virginia sits

The same service costs 8.3 times more in California than in West Virginia. 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.

West Virginia· 51st of 51

$275

CA $2,291WV $275

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.