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Balloon Opening of a Blocked Tear Duct

New York 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?

$4,074

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $4,074 for this service. Most negotiated rates run $2,138 to $6,457.

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 $4,074 · 10th to 90th $407 to $9,120
$200$500$1K$2K$5K$10Kfacility $4,074

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
$281.84
Median
$3,090.30
Typical High
$9,332.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$2,398.83
Typical High
$10,964.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$234.42
Typical High
$1,412.54
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$213.80
Typical High
$512.86
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$4,570.88
Typical High
$4,570.88
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$3,981.07
Typical High
$8,709.64
Univera
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$213.80
Typical High
$676.08

Where New York 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.

New York· 13th of 50

$4,074

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.