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Scope Treatment of a Ureterocele in the Bladder

New Hampshire 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 $3,890 · 10th–90th $1,202$11,4820%10%10th90th$3,890Professionalmedian $468 · 10th–90th $282$7940%10%10th90th$468$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
Facility
Modifier
Global
Typical Low
$100.00
Median
$2,398.83
Typical High
$11,481.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$302.00
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$549.54
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$478.63
Typical High
$851.14
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$9,549.93
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$478.63
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$512.86
Typical High
$1,023.29