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Prostate Cancer Urine Gene Score

New York 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?

$646

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $646 for this service. The price depends on where it is billed: about $589 from a physician practice, and about $1,318 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 9 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$589$417 to $759
FacilityA hospital or hospital-owned outpatient department$1,318$759 to $1,738

How much rates vary

Facilitymedian $1,318 · 10th to 90th $617 to $2,089Professionalmedian $589 · 10th to 90th $316 to $1,202
$0.1$1$10$100$1Kfacility $1,318professional $589

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
$616.60
Median
$1,348.96
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$588.84
Typical High
$741.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,995.26
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.03
Median
$831.76
Typical High
$1,819.70
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$3,630.78
Typical High
$3,630.78
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,258.93
Typical High
$2,951.21
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$1,445.44
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$758.58
Typical High
$1,348.96
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,445.44
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$758.58
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$758.58
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$457.09
Typical High
$1,047.13
Univera
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$758.58
Typical High
$870.96
Univera
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$758.58
Typical High
$1,819.70

Where New York 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.

New York· 32nd of 51

$646

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.