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Scope Treatment of a Ureterocele in the Bladder

Washington, DC 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 $4,074 · 10th–90th $302$7,7620%10%10th90th$4,074Professionalmedian $309 · 10th–90th $302$5750%50%10th90th$309$500.0$1.0K$2.0K$5.0K$10.0K$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
$302.00
Median
$4,073.80
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$331.13
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$3,235.94
Typical High
$7,079.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$812.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$275.42
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$10,000.00
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$724.44