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Balloon Opening of a Blocked Tear Duct

Delaware 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 October 2026.

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

$1,950

Typical total for the visit. In Delaware, October 2026.

Insurers have agreed to pay about $1,950 for this procedure. That total is two separate charges: $537 to the doctor who performs it, and $1,413 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$537$182 to $692
Facility feeThe hospital or surgery center$1,413$1,023 to $2,138

How much rates vary

Facilitymedian $1,413 · 10th to 90th $708 to $2,884Professionalmedian $537 · 10th to 90th $162 to $955
$100$200$500$1K$2K$5Kfacility $1,413professional $537

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$954.99
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$707.95
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$123.03
Median
$186.21
Typical High
$707.95
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$114.82
Median
$173.78
Typical High
$660.69
Cigna
Setting
Facility
Modifier
None
Typical Low
$234.42
Median
$1,479.11
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$275.42
Typical High
$676.08
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$6,456.54
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
United
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$1,258.93
Typical High
$2,570.40
United
Setting
Professional
Modifier
None
Typical Low
$154.88
Median
$363.08
Typical High
$776.25

Where Delaware sits

The same service costs 3.5 times more in Colorado than in Montana. 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.

Physician feeFacility fee

Delaware· 42nd of 51

$1,950

$537 physician + $1,413 facility

CO $4,667MT $1,347

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.