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Balloon Opening of a Blocked Tear Duct

California rates for HCPCS 68816

Opens a blocked tear duct by passing a fine probe down the drainage channel from the eyelid towards the nose, then inflating a small balloon inside it to stretch the passage open. It treats a constantly watery, sticky eye caused by tears that cannot drain away.

Rates data updated July 2026.

How much does Balloon Opening of a Blocked Tear Duct cost?

$4,365

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $4,365 for this service. Most negotiated rates run $2,818 to $6,310.

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 $1,622 to $13,490Professionalmedian $708 · 10th to 90th $141 to $1,622
$100$500$2K$10Kfacility $4,571professional $708

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
$2,187.76
Median
$6,456.54
Typical High
$17,782.79
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
$707.95
Median
$1,202.26
Typical High
$1,995.26
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$524.81
Typical High
$1,479.11
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$812.83
Typical High
$1,698.24
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$56.23
Typical High
$6,165.95
Providence
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$676.08
Typical High
$1,445.44
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 9.1 times more in Indiana than in Maine. 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· 10th of 50

$4,365

IN $6,457ME $708

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.