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Scope Treatment of a Ureterocele in the Bladder

Iowa 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 $4,898 · 10th–90th $603$9,3330%10%10th90th$4,898Professionalmedian $437 · 10th–90th $269$1,6980%10%10th90th$437$200.0$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
$933.25
Median
$4,897.79
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$416.87
Typical High
$1,698.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$676.08
Typical High
$812.83
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$501.19
Typical High
$1,318.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$3,162.28
Typical High
$9,332.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$588.84
Typical High
$2,137.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$691.83
Typical High
$1,047.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$6,456.54
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$489.78
Typical High
$912.01
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$512.86
Typical High
$602.56