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Telescope Removal of a Kidney or Ureter Stone

Montana 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?

$1,205

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

Insurers have agreed to pay about $1,205 for this procedure. That total is two separate charges: $603 to the doctor who performs it, and $603 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$603$398 to $617
Facility feeThe hospital or surgery center$603$589 to $724

How much rates vary

Facilitymedian $603 · 10th to 90th $589 to $4,365Professionalmedian $603 · 10th to 90th $79 to $676
$100$200$500$1K$2K$5K$10Kfacility $603professional $603

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
Professional
Modifier
None
Typical Low
$416.87
Median
$457.09
Typical High
$616.60
BCBS Montana
Setting
Facility
Modifier
None
Typical Low
$4,570.88
Median
$4,570.88
Typical High
$4,570.88
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Cigna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$4,365.16
Typical High
$12,589.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$588.84
Median
$588.84
Typical High
$676.08
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$380.19
Median
$588.84
Typical High
$630.96
Providence
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$4,365.16
Typical High
$12,589.25
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$524.81
Typical High
$616.60
United
Setting
Facility
Modifier
None
Typical Low
$2,089.30
Median
$3,981.07
Typical High
$7,079.46
United
Setting
Professional
Modifier
None
Typical Low
$588.84
Median
$660.69
Typical High
$933.25

Where Montana 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

Montana· 51st of 51

$1,205

$603 physician + $603 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.