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Balloon Opening of a Blocked Tear Duct

New Hampshire 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?

$2,469

Typical total for the visit. In New Hampshire, October 2026.

Insurers have agreed to pay about $2,469 for this procedure. That total is two separate charges: $380 to the doctor who performs it, and $2,089 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$380$219 to $1,072
Facility feeThe hospital or surgery center$2,089$1,698 to $2,512

How much rates vary

Facilitymedian $2,089 · 10th to 90th $1,585 to $3,890Professionalmedian $380 · 10th to 90th $170 to $1,698
$200$500$1K$2K$5K$10Kfacility $2,089professional $380

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
$2,398.83
Median
$2,398.83
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$645.65
Typical High
$776.25
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$1,513.56
Median
$1,737.80
Typical High
$3,890.45
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$275.42
Typical High
$1,071.52
Anthem BCBS
Setting
Professional
Modifier
50 · Both sides
Typical Low
$275.42
Median
$407.38
Typical High
$891.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$891.25
Median
$2,089.30
Typical High
$2,951.21
Cigna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$660.69
Typical High
$2,089.30
Harvard Pilgrim
Setting
Facility
Modifier
None
Typical Low
$1,698.24
Median
$1,949.84
Typical High
$4,265.80
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$891.25
Typical High
$2,570.40
United
Setting
Facility
Modifier
None
Typical Low
$1,698.24
Median
$2,089.30
Typical High
$4,265.80
United
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$794.33
Typical High
$1,737.80
Well Sense
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
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
$190.55
Median
$489.78
Typical High
$588.84
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$177.83
Median
$457.09
Typical High
$549.54

Where New Hampshire 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

New Hampshire· 23rd of 51

$2,469

$380 physician + $2,089 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.