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Scope Treatment of a Ureterocele in the Bladder

North Carolina 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 $1,096 · 10th–90th $282$8,7100%10%10th90th$1,096Professionalmedian $407 · 10th–90th $282$8710%20%10th90th$407$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
$281.84
Median
$1,288.25
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$954.99
BCBS
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$676.08
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$457.09
Typical High
$741.31
Medcost
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$398.11
Typical High
$602.56
Medcost
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$6,918.31
Typical High
$12,882.50
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$660.69
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$9,772.37
Typical High
$45,708.82
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,398.83