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Scope Treatment of a Ureterocele in the Bladder

Georgia 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 $4,266 · 10th–90th $977$7,4130%5%10%10th90th$4,266Professionalmedian $398 · 10th–90th $282$6170%10%10th90th$398$20.0$100.0$500.0$2.0K$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
$562.34
Median
$4,897.79
Typical High
$9,549.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$3,162.28
Typical High
$6,606.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$446.68
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$676.08
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$338.84
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$3,890.45
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$389.05
Typical High
$676.08