52351

Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope

Medicare pricing data for 6,516 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $260 in Arkansas to $643 in Maryland. 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

Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope (HCPCS code 52351) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $396.58, but hospitals typically charge $1,649 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$79.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $396.58, your out-of-pocket cost would be approximately $79.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$396.58
Average Hospital Charge
$1,649
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,649.47
Medicare Allowed$396.58
Medicare Payment$313.60

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $313.60 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$643$1,805154834+62.1%
Alaska$563$5,4891749+42.0%
Delaware$532$2,70524115+34.1%
Mississippi$528$1,75358334+33.2%
Tennessee$497$1,6941701,194+25.4%
Virginia$491$1,594169900+23.9%
Georgia$490$1,945217808+23.6%
Nevada$479$1,71034105+20.7%
Wyoming$475$2,0211029+19.7%
Colorado$470$3,329115345+18.4%
Oregon$469$1,62592288+18.4%
New Jersey$466$3,014231764+17.5%
Florida$439$1,8014961,792+10.8%
Missouri$432$1,683132473+9.0%
Idaho$416$1,0393188+5.0%
California$410$1,8914841,461+3.4%
Iowa$400$1,25554261+0.9%
Texas$387$1,7744151,180-2.3%
Arizona$386$1,730129418-2.7%
Ohio$378$1,3272921,305-4.6%
Illinois$364$1,8922641,067-8.2%
New York$363$1,5173801,224-8.4%
Nebraska$352$1,37647191-11.2%
Wisconsin$351$3,374130419-11.4%
Utah$350$1,09248114-11.7%
Indiana$343$1,619164688-13.5%
Pennsylvania$343$1,2373171,080-13.6%
Massachusetts$339$1,300172537-14.6%
South Carolina$334$1,634127669-15.7%
Montana$334$1,18629111-15.8%
Kansas$327$1,37765272-17.5%
Washington$325$921139482-17.9%
Rhode Island$324$8312257-18.2%
Connecticut$324$1,65991254-18.3%
Alabama$324$1,08392264-18.3%
Michigan$314$997204694-20.9%
North Carolina$311$1,209223636-21.5%
Hawaii$308$9501730-22.3%
Kentucky$305$98071330-23.2%
Minnesota$297$1,694106275-25.1%
Oklahoma$291$92077306-26.6%
Louisiana$281$850103262-29.1%
New Mexico$279$8502172-29.7%
New Hampshire$273$1,56941126-31.1%
West Virginia$273$1,12132142-31.1%
South Dakota$272$1,0261892-31.3%
Vermont$271$1,5311853-31.6%
North Dakota$266$1,0291328-32.8%
Maine$264$8302870-33.4%
District of Columbia$260$99819118-34.4%
Arkansas$260$82842185-34.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber