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Prostate Cancer Urine Gene Score

Massachusetts rates for HCPCS 0005U

Estimates the chance that a prostate biopsy would find cancer, using urine instead of tissue. It measures the activity of three genes — ERG, PCA3 and SPDEF — in a urine sample and reports a combined risk score.

Rates data updated July 2026.

How much does Prostate Cancer Urine Gene Score cost?

$759

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $759 for this service. The price depends on where it is billed: about $759 from a physician practice, and about $1,514 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 8 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$759$589 to $759
FacilityA hospital or hospital-owned outpatient department$1,514$1,096 to $2,188

How much rates vary

Facilitymedian $1,514 · 10th to 90th $759 to $2,455Professionalmedian $759 · 10th to 90th $457 to $1,549
$500$1K$2K$5Kfacility $1,514professional $759

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
$537.03
Median
$1,318.26
Typical High
$2,238.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$537.03
Typical High
$616.60
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,949.84
Typical High
$3,630.78
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$2,137.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,513.56
Typical High
$2,187.76
BCBS
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$588.84
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$933.25
Typical High
$1,148.15
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$4,897.79
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,288.25
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,513.56
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$1,949.84
Typical High
$3,630.78
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$1,737.80

Where Massachusetts sits

The same service costs 3.4 times more in Alaska than in Nebraska. 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.

Massachusetts· 14th of 51

$759

AK $1,698NE $501

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.