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Scope Treatment of a Ureterocele in the Bladder

West Virginia 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 $457 · 10th–90th $275$8,5110%20%40%10th90th$457Professionalmedian $302 · 10th–90th $275$3980%20%40%10th90th$302$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
$275.42
Median
$275.42
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$302.00
Typical High
$331.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$371.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$416.87
Typical High
$1,778.28
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,951.21
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$338.84
Typical High
$512.86