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Biopsy of the Tear Sac

New York 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?

$4,074

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $4,074 for this service. Most negotiated rates run $2,630 to $6,166.

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 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4,074 · 10th to 90th $427 to $8,913
$100.0$1.0K$10.0Kfacility $4,074

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
$323.59
Median
$3,090.30
Typical High
$7,762.47
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$1,258.93
Typical High
$4,073.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$1,659.59
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$234.42
Typical High
$524.81
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$3,981.07
Typical High
$8,709.64
Univera
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$346.74
Typical High
$870.96

Where New York sits

The same service costs 25.1 times more in Indiana than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New York $4,074 · 12th of 50
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.