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Scope Treatment of a Ureterocele in the Bladder

Idaho 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 $4,467 · 10th–90th $407$9,1200%10%10th90th$4,467Professionalmedian $417 · 10th–90th $302$6460%20%10th90th$417$50.0$200.0$1.0K$5.0K

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
$2,884.03
Median
$4,466.84
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$371.54
Typical High
$645.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$4,168.69
Typical High
$9,120.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$562.34
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$416.87
Typical High
$549.54
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$446.68
Typical High
$691.83
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$575.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$7,762.47
Typical High
$11,481.54
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$457.09
Typical High
$549.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$4,365.16
Typical High
$7,244.36
Select Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$12,302.69
Typical High
$12,302.69
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$398.11
Typical High
$588.84