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Scope Treatment of a Ureterocele in the Bladder

Montana 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 $490 · 10th–90th $490$6030%20%40%90th$490Professionalmedian $490 · 10th–90th $302$1,5140%20%10th90th$490$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Professional
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$1,513.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$446.68
Typical High
$489.78
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$602.56
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$602.56
Providence
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$426.58
Typical High
$562.34
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$338.84
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$489.78
Typical High
$724.44