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Scope Treatment of a Ureterocele in the Bladder

Missouri 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 $1,950 · 10th–90th $724$5,2480%5%10th90th$1,950Professionalmedian $355 · 10th–90th $269$2,1380%20%10th90th$355$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
$331.13
Median
$3,311.31
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$331.13
Typical High
$3,548.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,479.11
Typical High
$3,235.94
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$371.54
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$389.05
Typical High
$645.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$1,659.59
Typical High
$26,302.68
Medica
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$467.74
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$2,818.38
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$416.87
Typical High
$707.95