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Telescope Removal of a Kidney or Ureter Stone

Nebraska 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?

$4,925

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

Insurers have agreed to pay about $4,925 for this procedure. That total is two separate charges: $851 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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$851$708 to $977
Facility feeThe hospital or surgery center$4,074$2,399 to $7,586

How much rates vary

Facilitymedian $4,074 · 10th to 90th $1,288 to $13,183Professionalmedian $851 · 10th to 90th $513 to $3,981
$500$1K$2K$5K$10K$20Kfacility $4,074professional $851

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
$776.25
Median
$7,079.46
Typical High
$12,589.25
Aetna
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$436.52
Typical High
$1,445.44
Ambetter
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$870.96
BCBS Nebraska
Setting
Facility
Modifier
None
Typical Low
$10,000.00
Median
$13,182.57
Typical High
$26,915.35
BCBS Nebraska
Setting
Professional
Modifier
None
Typical Low
$3,630.78
Median
$3,890.45
Typical High
$3,981.07
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,288.25
Median
$3,467.37
Typical High
$4,786.30
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$870.96
Typical High
$1,174.90
Medica
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$3,162.28
Typical High
$14,454.40
Medica
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$831.76
Typical High
$6,309.57
Midlands
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$870.96
Typical High
$1,202.26
Midlands
Setting
Facility
Modifier
None
Typical Low
$1,288.25
Median
$3,630.78
Typical High
$5,011.87
Midlands
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$741.31
Typical High
$851.14
United
Setting
Facility
Modifier
None
Typical Low
$1,380.38
Median
$3,162.28
Typical High
$7,413.10
United
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$851.14
Typical High
$1,122.02

Where Nebraska 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

Nebraska· 21st of 51

$4,925

$851 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.