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Scope Treatment of a Ureterocele in the Bladder

North Dakota 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 $288 · 10th–90th $269$8,5110%20%40%10th90th$288Professionalmedian $562 · 10th–90th $288$7240%10%20%10th90th$562$500.0$1.0K$2.0K$5.0K

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
$269.15
Median
$288.40
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$288.40
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$616.60
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$537.03
Typical High
$870.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$870.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$524.81
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$5,128.61
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$501.19
Typical High
$724.44