Insertion of tube into ureter using an endoscope through bladder area
Medicare pricing data for 6,156 providers across 52 states
This procedure has a 7.0x markup — hospitals charge $1,255 but Medicare allows only $178.68. Uninsured patients may face bills 7.0 times higher than what insurance negotiates. Prices vary significantly by location — from $77 in Nevada to $337 in Mississippi. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Insertion of tube into ureter using an endoscope through bladder area (HCPCS code 52005) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $178.68, but hospitals typically charge $1,255 — a 7.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $178.68, your out-of-pocket cost would be approximately $35.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $140.41 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Mississippi | $337 | $1,340 | 59 | 872 | +88.3% |
| Georgia | $302 | $1,576 | 218 | 1,881 | +69.3% |
| Nebraska | $282 | $1,337 | 46 | 300 | +57.9% |
| New Jersey | $270 | $2,715 | 233 | 1,592 | +51.1% |
| Wyoming | $267 | $2,653 | 10 | 21 | +49.5% |
| Hawaii | $262 | $1,337 | 15 | 66 | +46.4% |
| Alaska | $246 | $3,187 | 23 | 128 | +37.7% |
| Maryland | $232 | $1,715 | 144 | 716 | +29.6% |
| Ohio | $228 | $1,698 | 253 | 1,233 | +27.3% |
| Virginia | $206 | $930 | 170 | 748 | +15.1% |
| Florida | $191 | $1,169 | 512 | 2,598 | +7.1% |
| Oregon | $187 | $1,056 | 68 | 175 | +4.4% |
| Missouri | $183 | $1,117 | 135 | 549 | +2.2% |
| Louisiana | $179 | $1,217 | 96 | 681 | +0.2% |
| South Carolina | $177 | $1,258 | 129 | 1,065 | -0.7% |
| California | $175 | $1,241 | 441 | 1,414 | -2.0% |
| Colorado | $155 | $1,181 | 85 | 194 | -13.5% |
| Kansas | $149 | $808 | 57 | 255 | -16.5% |
| Tennessee | $145 | $939 | 147 | 596 | -19.1% |
| New York | $143 | $1,253 | 353 | 1,168 | -19.8% |
| Massachusetts | $143 | $989 | 166 | 795 | -20.2% |
| Pennsylvania | $142 | $849 | 305 | 1,189 | -20.5% |
| Minnesota | $138 | $1,156 | 111 | 299 | -22.7% |
| Kentucky | $136 | $663 | 64 | 317 | -24.0% |
| Illinois | $135 | $1,153 | 261 | 1,153 | -24.4% |
| Rhode Island | $135 | $713 | 25 | 84 | -24.4% |
| Indiana | $134 | $1,353 | 168 | 621 | -25.1% |
| Delaware | $134 | $688 | 25 | 107 | -25.2% |
| Utah | $132 | $1,310 | 38 | 98 | -26.2% |
| New Hampshire | $131 | $1,309 | 37 | 124 | -26.8% |
| Washington | $124 | $636 | 103 | 271 | -30.6% |
| Michigan | $124 | $686 | 208 | 867 | -30.6% |
| Alabama | $120 | $714 | 77 | 333 | -32.6% |
| Texas | $119 | $1,005 | 348 | 1,118 | -33.7% |
| Oklahoma | $111 | $841 | 95 | 683 | -38.0% |
| District of Columbia | $109 | $600 | 21 | 73 | -38.7% |
| Wisconsin | $109 | $2,170 | 118 | 403 | -39.0% |
| Connecticut | $109 | $1,171 | 74 | 221 | -39.1% |
| New Mexico | $107 | $777 | 24 | 61 | -40.4% |
| Iowa | $106 | $1,089 | 62 | 222 | -40.4% |
| West Virginia | $104 | $569 | 38 | 366 | -41.7% |
| Arkansas | $103 | $606 | 47 | 231 | -42.1% |
| Arizona | $103 | $821 | 103 | 434 | -42.3% |
| Vermont | $102 | $1,687 | 12 | 21 | -42.9% |
| North Carolina | $102 | $1,034 | 193 | 610 | -43.1% |
| Idaho | $99 | $537 | 30 | 126 | -44.7% |
| South Dakota | $96 | $1,094 | 25 | 214 | -46.3% |
| Montana | $95 | $650 | 23 | 86 | -46.9% |
| Maine | $95 | $556 | 29 | 75 | -46.9% |
| Puerto Rico | $95 | $190 | 6 | 14 | -47.1% |
| North Dakota | $84 | $833 | 7 | 26 | -53.0% |
| Nevada | $77 | $1,027 | 35 | 162 | -57.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber