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Prostate Cancer Urine Gene Score

Maine 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 Maine, 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 $1,000 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 6 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$617 to $759
FacilityA hospital or hospital-owned outpatient department$1,000$759 to $3,388

How much rates vary

Facilitymedian $1,000 · 10th to 90th $759 to $4,898Professionalmedian $759 · 10th to 90th $457 to $776
$500$1K$2K$5Kfacility $1,000professional $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
$758.58
Median
$758.58
Typical High
$1,905.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$616.60
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$4,897.79
Typical High
$5,248.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$912.01
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,905.46
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$616.60
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$1,148.15

Where Maine 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.

Maine· 20th 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.