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Balloon Opening of a Blocked Tear Duct

Maine 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?

$2,054

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

Insurers have agreed to pay about $2,054 for this procedure. That total is two separate charges: $275 to the doctor who performs it, and $1,778 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$275$224 to $1,047
Facility feeThe hospital or surgery center$1,778$1,479 to $2,089

How much rates vary

Facilitymedian $1,778 · 10th to 90th $708 to $3,236Professionalmedian $275 · 10th to 90th $170 to $1,318
$100$200$500$1K$2Kfacility $1,778professional $275

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
Professional
Modifier
None
Typical Low
$239.88
Median
$660.69
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$169.82
Median
$169.82
Typical High
$851.14
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$208.93
Typical High
$616.60
Anthem BCBS
Setting
Professional
Modifier
50 · Both sides
Typical Low
$208.93
Median
$316.23
Typical High
$446.68
Cigna
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$1,479.11
Typical High
$3,235.94
Cigna
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$354.81
Typical High
$1,548.82
Harvard Pilgrim
Setting
Facility
Modifier
None
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$3,311.31
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$512.86
Typical High
$1,258.93
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$707.95
Typical High
$1,230.27
Martin's Point
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$169.82
Median
$169.82
Typical High
$851.14
United
Setting
Facility
Modifier
None
Typical Low
$1,071.52
Median
$1,778.28
Typical High
$3,311.31
United
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$512.86
Typical High
$1,148.15
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$181.97
Median
$181.97
Typical High
$912.01
Martin's Point
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$181.97
Median
$181.97
Typical High
$912.01

Where Maine 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

Maine· 34th of 51

$2,054

$275 physician + $1,778 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.