go back

Scope Procedure To Break Up A Kidney Or Ureter Stone

Pennsylvania 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?

$8,287

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

Insurers have agreed to pay about $8,287 for this procedure. That total is two separate charges: $525 to the doctor who performs it, and $7,762 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 13 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$525$427 to $832
Facility feeThe hospital or surgery center$7,762$5,370 to $9,772

How much rates vary

Facilitymedian $7,762 · 10th to 90th $2,818 to $15,849Professionalmedian $525 · 10th to 90th $372 to $1,148
$200$500$1K$2K$5K$10K$20Kfacility $7,762professional $525

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
$2,818.38
Median
$7,762.47
Typical High
$15,488.17
Aetna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$3,801.89
Median
$9,120.11
Typical High
$43,651.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$537.03
Typical High
$1,148.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$549.54
Typical High
$707.95
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$7,413.10
Typical High
$47,863.01
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$354.81
Typical High
$467.74
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$10,000.00
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$630.96
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$524.81
Typical High
$812.83
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$616.60
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,754.23
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$501.19
Typical High
$758.58
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$11,220.18
Typical High
$20,417.38
Highmark BCBS
Setting
Facility
Modifier
22 · Increased work
Typical Low
$13,182.57
Median
$13,182.57
Typical High
$13,182.57
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$3,388.44
Median
$12,589.25
Typical High
$30,902.95
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$512.86
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$6,025.60
Typical High
$33,884.42
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$426.58
Typical High
$457.09
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$8,317.64
Typical High
$16,218.10
Martin's Point
Setting
Facility
Modifier
22 · Increased work
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
Martin's Point
Setting
Facility
Modifier
50 · Both sides
Typical Low
$5,011.87
Median
$9,120.11
Typical High
$38,904.51
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$512.86
Typical High
$1,318.26
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$8,511.38
Typical High
$12,882.50
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$457.09
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$5,370.32
Typical High
$9,772.37
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$407.38
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,370.32
Typical High
$15,848.93
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$489.78
Typical High
$831.76

Where Pennsylvania 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

Pennsylvania· 15th of 51

$8,287

$525 physician + $7,762 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.