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Balloon Opening of a Blocked Tear Duct

Pennsylvania 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?

$3,802

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $3,802 for this service. Most negotiated rates run $1,820 to $5,370.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,802 · 10th to 90th $955 to $8,318
$200$500$1K$2K$5K$10Kfacility $3,802

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
$954.99
Median
$3,890.45
Typical High
$8,317.64
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$6,165.95
Typical High
$57,543.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$7,943.28
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$3,090.30
Typical High
$8,317.64
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$3,311.31
Typical High
$5,754.40
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$3,630.78
Typical High
$7,413.10

Where Pennsylvania 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.

Pennsylvania· 15th of 50

$3,802

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.