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Telescope Removal of a Kidney or Ureter Stone

New Hampshire 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?

$5,263

Typical total for the visit. In New Hampshire, October 2026.

Insurers have agreed to pay about $5,263 for this procedure. That total is two separate charges: $692 to the doctor who performs it, and $4,571 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$692$562 to $891
Facility feeThe hospital or surgery center$4,571$2,630 to $5,623

How much rates vary

Facilitymedian $4,571 · 10th to 90th $2,344 to $8,710Professionalmedian $692 · 10th to 90th $407 to $1,288
$500$1K$2K$5K$10Kfacility $4,571professional $692

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$616.60
Median
$2,398.83
Typical High
$14,791.08
Aetna
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$616.60
Typical High
$676.08
Ambetter
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$5,011.87
Median
$5,623.41
Typical High
$9,332.54
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$741.31
Typical High
$1,380.38
Anthem BCBS
Setting
Professional
Modifier
50 · Both sides
Typical Low
$660.69
Median
$1,122.02
Typical High
$2,089.30
Cigna
Setting
Facility
Modifier
None
Typical Low
$812.83
Median
$4,786.30
Typical High
$6,606.93
Cigna
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$645.65
Typical High
$1,148.15
Harvard Pilgrim
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$3,467.37
Typical High
$5,754.40
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$660.69
Typical High
$1,288.25
United
Setting
Facility
Modifier
None
Typical Low
$2,344.23
Median
$3,548.13
Typical High
$5,754.40
United
Setting
Professional
Modifier
None
Typical Low
$457.09
Median
$616.60
Typical High
$1,288.25
Well Sense
Setting
Facility
Modifier
None
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24

Where New Hampshire 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

New Hampshire· 16th of 51

$5,263

$692 physician + $4,571 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.