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Biopsy of the Tear Sac

Pennsylvania 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?

$2,692

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $2,692 for this service. Most negotiated rates run $1,514 to $5,370.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,692 · 10th to 90th $661 to $8,318
$500$1K$2K$5K$10Kfacility $2,692

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
$660.69
Median
$2,691.53
Typical High
$8,317.64
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,165.95
Typical High
$57,543.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,398.83
Typical High
$8,317.64
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,288.25
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$3,630.78
Typical High
$7,413.10

Where Pennsylvania 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.

Pennsylvania· 21st of 50

$2,692

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.