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Biopsy of the Tear Sac

California rates for HCPCS 68525

Takes a sample of tissue from the tear sac, the small pouch beside the nose that collects tears before they drain into the nasal cavity. The sample is examined under a microscope to find out what is behind a swelling, a blockage, or a lump in that area. The sac itself is left in place.

Rates data updated July 2026.

How much does Biopsy of the Tear Sac cost?

$4,467

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $4,467 for this service. Most negotiated rates run $2,818 to $6,457.

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.

How much rates vary

Facilitymedian $4,571 · 10th to 90th $1,698 to $13,490Professionalmedian $257 · 10th to 90th $195 to $417
$100$500$2K$10Kfacility $4,571professional $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
$1,737.80
Median
$5,888.44
Typical High
$17,378.01
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$4,466.84
Typical High
$12,882.50
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$3,235.94
Typical High
$6,606.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$549.54
Typical High
$1,995.26
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$257.04
Typical High
$489.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$245.47
Typical High
$416.87
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$19,498.45
Typical High
$19,498.45
Providence
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$295.12
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$7,244.36
Typical High
$15,135.61

Where California sits

The same service costs 25.1 times more in Indiana than in Maryland. 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.

California· 9th of 50

$4,467

IN $6,310MD $251

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.