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Scope Treatment of a Ureterocele in the Bladder

Utah 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 $4,898 · 10th–90th $417$8,9130%10%10th90th$4,898Professionalmedian $407 · 10th–90th $275$9550%10%10th90th$407$50.0$200.0$1.0K$5.0K

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
$416.87
Median
$4,570.88
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$363.08
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$407.38
Typical High
$602.56
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$812.83
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$6,760.83
Typical High
$10,232.93
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$436.52
Typical High
$616.60
Select Health
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$524.81
Select Health
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$478.63
Typical High
$549.54
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$436.52
Typical High
$1,288.25
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$5,128.61
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$602.56