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Aggressive Prostate Cancer Gene Risk Score

Texas rates for HCPCS 0011M

Estimates the likelihood that a person has aggressive prostate cancer rather than slow-growing disease. It measures the activity of 12 genes across two body fluids — urine and blood plasma — and reports one combined risk score.

Rates data updated July 2026.

How much does Aggressive Prostate Cancer Gene Risk Score cost?

$575

Typical negotiated rate. In Texas, July 2026.

Insurers have agreed to pay about $575 for this service. The price depends on where it is billed: about $490 from a physician practice, and about $912 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$490$457 to $575
FacilityA hospital or hospital-owned outpatient department$912$575 to $1,413

How much rates vary

Facilitymedian $912 · 10th to 90th $457 to $3,388Professionalmedian $490 · 10th to 90th $398 to $794
$100$200$500$1K$2K$5Kfacility $912professional $490

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
$457.09
Median
$912.01
Typical High
$3,388.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$501.19
Typical High
$645.65
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,513.56
Typical High
$3,388.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$831.76
Typical High
$1,000.00
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$3,630.78
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$5,754.40
Typical High
$5,754.40
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$758.58
Typical High
$1,174.90
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$954.99
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$891.25
Typical High
$2,818.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$758.58
Typical High
$2,238.72
Providence
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$758.58
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$758.58
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$758.58
Typical High
$1,023.29

Where Texas 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.

Texas· 47th of 51

$575

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.