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Scope Treatment of a Ureterocele in the Bladder

Oregon 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 $562 · 10th–90th $372$11,2200%20%40%10th90th$562Professionalmedian $537 · 10th–90th $302$9120%20%10th90th$537$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$707.95
Median
$7,943.28
Typical High
$17,378.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$436.52
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$602.56
Typical High
$812.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$537.03
Typical High
$724.44
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$457.09
Typical High
$691.83
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$512.86
Typical High
$758.58
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$562.34
Typical High
$575.44
Providence
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$724.44
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$549.54
Typical High
$776.25
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$11,481.54
Typical High
$13,803.84
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$676.08
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$9,549.93
Typical High
$12,022.64
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$562.34
Typical High
$812.83