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Scope Treatment of a Ureterocele in the Bladder

Kentucky 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 $3,981 · 10th–90th $1,288$15,1360%5%10%10th90th$3,981Professionalmedian $324 · 10th–90th $269$6170%20%10th90th$324$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
$346.74
Median
$851.14
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$302.00
Typical High
$933.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$5,011.87
Typical High
$15,848.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$323.59
Typical High
$436.52
CareSource
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$363.08
Typical High
$426.58
CareSource
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$489.78
Typical High
$1,778.28
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$3,467.37
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$389.05
Typical High
$562.34