go back

Scope Procedure To Break Up A Kidney Or Ureter Stone

West Virginia 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?

$10,421

Typical total for the visit. In West Virginia, July 2026.

Insurers have agreed to pay about $10,421 for this procedure. That total is two separate charges: $871 to the doctor who performs it, and $9,550 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$871$832 to $891
Facility feeThe hospital or surgery center$9,550$5,623 to $16,596

How much rates vary

Facilitymedian $9,550 · 10th to 90th $2,042 to $23,442Professionalmedian $871 · 10th to 90th $437 to $912
$500$1K$2K$5K$10K$20Kfacility $9,550professional $871

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
$2,041.74
Median
$9,549.93
Typical High
$23,442.29
Aetna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$30,199.52
Median
$30,199.52
Typical High
$30,199.52
Aetna
Setting
Facility
Modifier
50 · Both sides
Typical Low
$8,709.64
Median
$8,709.64
Typical High
$11,220.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$870.96
Typical High
$912.01
CareSource
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$537.03
Typical High
$549.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$467.74
Typical High
$645.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$645.65
Typical High
$645.65
Cigna
Setting
Facility
Modifier
22 · Increased work
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$588.84
Typical High
$1,778.28
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$22,387.21
Typical High
$29,512.09
Highmark BCBS
Setting
Facility
Modifier
50 · Both sides
Typical Low
$9,549.93
Median
$16,982.44
Typical High
$35,481.34
United
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$7,943.28
Typical High
$15,135.61
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$489.78
Typical High
$741.31

Where West Virginia 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

West Virginia· 5th of 51

$10,421

$871 physician + $9,550 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.