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Scope Treatment of a Ureterocele in the Bladder

Massachusetts 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 $3,090 · 10th–90th $295$5,8880%5%10%10th90th$3,090Professionalmedian $363 · 10th–90th $263$9330%20%10th90th$363$100.0$500.0$2.0K$10.0K$50.0K

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
$1,778.28
Median
$3,311.31
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$309.03
Typical High
$933.25
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$5,370.32
Typical High
$45,708.82
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$416.87
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$426.58
Typical High
$758.58
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$323.59
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$275.42
Typical High
$416.87
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$4,265.80
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$467.74
Typical High
$794.33
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$5,370.32
Typical High
$45,708.82
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$416.87
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$4,265.80
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$501.19
Typical High
$1,202.26