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Scope Treatment of a Ureterocele in the Bladder

Arkansas 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 $1,820 · 10th–90th $417$3,7150%10%10th90th$1,820Professionalmedian $389 · 10th–90th $269$4790%20%10th90th$389$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,380.38
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$398.11
Typical High
$478.63
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$4,466.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$2,570.40
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$478.63
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$2,290.87
Typical High
$7,079.46
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$549.54