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Scope Treatment of a Ureterocele in the Bladder

New York 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 $4,786 · 10th–90th $525$10,9650%5%10th90th$4,786Professionalmedian $355 · 10th–90th $245$8910%10%10th90th$355$100.0$500.0$2.0K$10.0K$50.0K

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
$398.11
Median
$3,890.45
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$1,047.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,495.41
Typical High
$12,882.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$741.31
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$1,995.26
Typical High
$8,912.51
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$5,754.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$537.03
Typical High
$1,348.96
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$512.86
Typical High
$977.24
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$389.05
Typical High
$549.54
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$389.05
Typical High
$602.56
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$407.38
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$3,981.07
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$398.11
Typical High
$954.99
Univera
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$371.54
Typical High
$1,023.29
Univera
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$371.54
Typical High
$912.01