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Scope Treatment of a Ureterocele in the Bladder

Alaska rates for HCPCS 52301

A thin telescope is passed along the urine channel into the bladder, and a ureterocele — a balloon-like swelling at the end of the tube bringing urine down from the kidney — is cut open or destroyed so urine can drain freely. It is done entirely through the natural opening, with no external incision.

Rates data updated July 2026.

Facilitymedian $708 · 10th–90th $288$10,9650%10%10th90th$708Professionalmedian $1,023 · 10th–90th $288$1,8620%10%20%10th90th$1,023$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$10,715.19
Typical High
$14,125.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$741.31
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$380.19
Typical High
$1,000.00
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$1,905.46
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$1,023.29
Typical High
$2,041.74
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,819.70
Providence
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$1,905.46
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$630.96
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$812.83
Typical High
$1,905.46