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Scope Treatment of a Ureterocele in the Bladder

Tennessee 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 $3,090 · 10th–90th $933$9,7720%10%10th90th$3,090Professionalmedian $363 · 10th–90th $282$9770%20%10th90th$363$200.0$1.0K$5.0K$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
$707.95
Median
$2,454.71
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$4,073.80
Typical High
$5,888.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$426.58
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$389.05
Typical High
$588.84
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$9,772.37
Typical High
$45,708.82
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$2,398.83
Typical High
$2,398.83
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,467.37
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$398.11
Typical High
$645.65