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Prostate Cancer Urine Gene Score

Illinois rates for HCPCS 81313

A urine test, collected straight after a doctor examines the prostate, that measures two prostate-specific genetic messages and reports their ratio as a score. A higher score means a biopsy is more likely to find cancer, so it helps decide whether a biopsy is worth doing when a PSA result is borderline.

Facilitymedian $437 · 10th–90th $257$7760%10%10th90th$437Professionalmedian $214 · 10th–90th $174$4370%20%40%10th90th$214$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$213.80
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$891.25
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$549.54
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$309.03
Typical High
$426.58
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$407.38
Typical High
$630.96
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$131.83
Typical High
$263.03