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Telescope Removal of a Kidney or Ureter Stone

Louisiana rates for HCPCS 52353

A slim telescope is passed up through the urethra and bladder into the ureter, and sometimes on into the kidney, until the stone is in view. Energy delivered through the scope — usually a laser fiber — breaks the stone into fragments small enough to be picked out or passed naturally. Nothing is cut on the outside; a temporary internal drainage tube is often left afterwards and is billed separately.

Rates data updated October 2026.

How much does Telescope Removal of a Kidney or Ureter Stone cost?

$4,623

Typical total for the visit. In Louisiana, October 2026.

Insurers have agreed to pay about $4,623 for this procedure. That total is two separate charges: $550 to the doctor who performs it, and $4,074 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$550$457 to $646
Facility feeThe hospital or surgery center$4,074$2,884 to $6,310

How much rates vary

Facilitymedian $4,074 · 10th to 90th $1,230 to $9,772Professionalmedian $550 · 10th to 90th $380 to $692
$500$1K$2K$5K$10Kfacility $4,074professional $550

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$562.34
Median
$2,398.83
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$616.60
Typical High
$691.83
Ambetter
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$416.87
Typical High
$436.52
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$3,162.28
Median
$4,365.16
Typical High
$10,471.29
BCBS Louisiana
Setting
Professional
Modifier
None
Typical Low
$489.78
Median
$575.44
Typical High
$645.65
Christus
Setting
Facility
Modifier
None
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$1,348.96
Typical High
$4,365.16
Cigna
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$512.86
Typical High
$630.96
United
Setting
Facility
Modifier
None
Typical Low
$1,202.26
Median
$3,019.95
Typical High
$11,481.54
United
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$489.78
Typical High
$741.31
5 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$263.03
Median
$309.03
Typical High
$331.13
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$104.71
Median
$123.03
Typical High
$131.83
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$389.05
Median
$467.74
Typical High
$501.19
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$77.62
Median
$93.33
Typical High
$100.00
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$52.48
Median
$61.66
Typical High
$66.07

Where Louisiana sits

The same service costs 7.3 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Louisiana· 24th of 51

$4,623

$550 physician + $4,074 facility

WI $8,816MT $1,205

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.