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Scope Treatment of a Ureterocele in the Bladder

Illinois 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 $2,138 · 10th–90th $550$7,7620%5%10th90th$2,138Professionalmedian $355 · 10th–90th $269$1,0230%20%10th90th$355$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
$549.54
Median
$1,862.09
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$302.00
Typical High
$912.01
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,128.61
Typical High
$7,244.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$512.86
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$398.11
Typical High
$602.56
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$467.74
Typical High
$1,584.89
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$363.08
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,388.44
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$630.96