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Scope Treatment of a Ureterocele in the Bladder

Indiana 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 $10,233 · 10th–90th $1,738$17,7830%5%10%10th90th$10,233Professionalmedian $339 · 10th–90th $269$6030%10%20%10th90th$339$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
$323.59
Median
$4,897.79
Typical High
$11,220.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$302.00
Typical High
$524.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$11,481.54
Typical High
$18,620.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$407.38
Typical High
$616.60
CareSource
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$288.40
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$2,238.72
Typical High
$2,238.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$398.11
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$5,623.41
Typical High
$10,715.19
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$338.84
Typical High
$562.34