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Biopsy of the Tear Sac

Illinois 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?

$1,259

Typical facility fee. In Illinois, July 2026.

Insurers have agreed to pay about $1,259 for this service. Most negotiated rates run $537 to $3,236.

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.

How much rates vary

Facilitymedian $1,862 · 10th to 90th $490 to $5,623Professionalmedian $398 · 10th to 90th $245 to $871
$200$500$1K$2K$5K$10Kfacility $1,862professional $398

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
$436.52
Median
$1,380.38
Typical High
$5,623.41
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$3,467.37
Typical High
$5,495.41
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$398.11
Typical High
$870.96
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,388.44
Typical High
$6,309.57

Where Illinois 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.

Illinois· 39th of 50

$1,259

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.