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Telescope Removal of a Kidney or Ureter Stone

Pennsylvania 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 July 2026.

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

$5,754

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $5,754 for this service. Most negotiated rates run $3,802 to $8,318.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,754 · 10th to 90th $1,047 to $12,589
$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $5,754

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$6,025.60
Typical High
$12,589.25
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$8,912.51
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$5,011.87
Typical High
$20,892.96
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$8,709.64
Typical High
$57,543.99
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$8,317.64
Typical High
$19,054.61
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$2,238.72
Median
$9,332.54
Typical High
$16,218.10
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$13,182.57
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$5,623.41
Typical High
$12,302.69
Martin's Point
Setting
Facility
Modifier
50 · Both sides
Typical Low
$8,912.51
Median
$8,912.51
Typical High
$8,912.51
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$2,041.74
Typical High
$4,168.69
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,370.32
Typical High
$15,848.93

Where Pennsylvania sits

The same service costs 18.6 times more in Indiana than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $5,754 · 23rd of 51
IN $10,965MD $589

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.