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Scope Treatment of a Ureterocele in the Bladder

California 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 $6,026 · 10th–90th $2,818$13,8040%5%10th90th$6,026Professionalmedian $363 · 10th–90th $251$1,6980%10%10th90th$363$50.0$200.0$1.0K$5.0K$20.0K

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
$2,754.23
Median
$6,760.83
Typical High
$19,054.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$5,011.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,888.44
Typical High
$13,489.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$478.63
Typical High
$912.01
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$4,466.84
Typical High
$9,332.54
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$2,089.30
Typical High
$2,454.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$371.54
Typical High
$831.76
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$380.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$316.23
Typical High
$602.56
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$45,708.82
Typical High
$45,708.82
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,398.83
Typical High
$2,398.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Providence
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$398.11
Typical High
$602.56
Providence
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$371.54
Typical High
$758.58
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$933.25
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$331.13
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$7,413.10
Typical High
$15,135.61
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$363.08
Typical High
$831.76