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Removing a Urethral Pouch in a Male

South Dakota rates for HCPCS 53235

Removes an abnormal pouch that has formed off the urethra, the tube that carries urine out of the body, in a male patient. The pouch traps urine and causes infection, dribbling, or pain; it is cut away and the urethra is repaired around the opening.

Rates data updated July 2026.

How much does Removing a Urethral Pouch in a Male cost?

$1,122

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $1,122 for this service. The price depends on where it is billed: about $1,096 from a physician practice, and about $1,698 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,096$646 to $1,479
FacilityA hospital or hospital-owned outpatient department$1,698$912 to $3,548

How much rates vary

Facilitymedian $1,698 · 10th to 90th $776 to $4,365Professionalmedian $1,096 · 10th to 90th $550 to $1,820
$1K$2K$5K$10Kfacility $1,698professional $1,096

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. 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
Global
Typical Low
$630.96
Median
$3,548.13
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,479.11
Typical High
$1,819.70
Medica
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$1,096.48
Typical High
$1,698.24
Medica
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$1,148.15
Typical High
$5,370.32
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,380.38
Typical High
$1,479.11
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,071.52
Typical High
$1,230.27
United
Setting
Facility
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$10,964.78
United
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,258.93
Typical High
$1,778.28
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,348.96
Typical High
$1,412.54

Where South Dakota sits

The same service costs 8.3 times more in California than in Delaware. 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.

South Dakota· 23rd of 51

$1,122

CA $5,623DE $676

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.