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Scope Treatment of a Ureterocele in the Bladder

Nebraska 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 $7,943 · 10th–90th $3,890$14,4540%10%10th90th$7,943Professionalmedian $525 · 10th–90th $263$1,5140%10%20%10th90th$525$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
$5,754.40
Median
$8,511.38
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$524.81
Typical High
$1,513.56
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$5,128.61
Typical High
$10,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$645.65
Typical High
$812.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$645.65
Typical High
$7,943.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$602.56
Typical High
$2,137.96
Midlands
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$676.08
Typical High
$891.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$4,365.16
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$602.56
Typical High
$812.83