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Scope Procedure To Break Up A Kidney Or Ureter Stone

Illinois rates for HCPCS 52356

A thin scope is passed up through the urinary tract to reach a stone in the ureter or kidney, where a laser or other device breaks it into smaller pieces that can pass or be removed. This version also includes placing a temporary stent in the ureter afterward to help urine drain while the area heals.

Rates data updated July 2026.

How much does Scope Procedure To Break Up A Kidney Or Ureter Stone cost?

$7,682

Typical total for the visit. In Illinois, July 2026.

Insurers have agreed to pay about $7,682 for this procedure. That total is two separate charges: $603 to the doctor who performs it, and $7,079 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$603$427 to $832
Facility feeThe hospital or surgery center$7,079$2,512 to $9,550

How much rates vary

Facilitymedian $7,079 · 10th to 90th $1,202 to $14,791Professionalmedian $603 · 10th to 90th $407 to $1,479
$100$500$2K$10Kfacility $7,079professional $603

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
$1,174.90
Median
$7,079.46
Typical High
$14,791.08
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$2,398.83
Median
$8,317.64
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$602.56
Typical High
$1,659.59
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$436.52
Typical High
$489.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$7,762.47
Typical High
$10,964.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$741.31
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$12,022.64
Typical High
$12,022.64
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$562.34
Typical High
$831.76
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$691.83
Typical High
$2,290.87
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$524.81
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$5,370.32
Typical High
$12,589.25
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$588.84
Typical High
$912.01

Where Illinois sits

The same service costs 5.1 times more in Wyoming than in Arkansas. 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

Illinois· 24th of 51

$7,682

$603 physician + $7,079 facility

WY $14,876AR $2,907

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.