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Balloon Opening of a Blocked Tear Duct

New Jersey 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?

$3,394

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

Insurers have agreed to pay about $3,394 for this procedure. That total is two separate charges: $575 to the doctor who performs it, and $2,818 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$575$151 to $776
Facility feeThe hospital or surgery center$2,818$1,698 to $4,898

How much rates vary

Facilitymedian $2,818 · 10th to 90th $871 to $7,586Professionalmedian $575 · 10th to 90th $126 to $933
$100$200$500$1K$2K$5K$10Kfacility $2,818professional $575

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$4,786.30
Typical High
$10,232.93
Aetna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$645.65
Typical High
$707.95
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$173.78
Median
$194.98
Typical High
$537.03
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$162.18
Median
$181.97
Typical High
$501.19
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,148.15
Median
$2,089.30
Typical High
$3,801.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$524.81
Typical High
$1,000.00
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,380.38
Typical High
$1,380.38
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$1,659.59
Median
$2,951.21
Typical High
$8,912.51
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$851.14
Typical High
$1,318.26
United
Setting
Facility
Modifier
None
Typical Low
$1,122.02
Median
$2,884.03
Typical High
$6,760.83
United
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$524.81
Typical High
$870.96

Where New Jersey 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 Jersey· 10th of 51

$3,394

$575 physician + $2,818 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.