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Prostate Cancer Urine And PSA Risk Test

Illinois rates for HCPCS 0113U

Estimates the risk that a man has prostate cancer, to help decide whether a biopsy is warranted. It measures two RNA markers in urine, PCA3 and the TMPRSS2-ERG fusion, and combines them with the PSA protein level from blood into a single risk score.

Rates data updated July 2026.

How much does Prostate Cancer Urine And PSA Risk Test cost?

$724

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $1,148 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 5 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$617$562 to $724
FacilityA hospital or hospital-owned outpatient department$1,148$776 to $1,514

How much rates vary

Facilitymedian $1,148 · 10th to 90th $617 to $1,660Professionalmedian $617 · 10th to 90th $417 to $1,318
$500$1K$2Kfacility $1,148professional $617

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
$1,148.15
Typical High
$1,621.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$616.60
Typical High
$1,548.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$1,023.29
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,445.44
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$933.25
Typical High
$1,122.02
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$1,023.29
Typical High
$1,412.54
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,513.56
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$457.09
Typical High
$758.58

Where Illinois 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.

Illinois· 21st of 51

$724

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.