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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.

Rates data updated July 2026.

How much does Prostate Cancer Urine Gene Score cost?

$257

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $398 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$214$204 to $309
FacilityA hospital or hospital-owned outpatient department$398$263 to $525

How much rates vary

Facilitymedian $398 · 10th to 90th $219 to $692Professionalmedian $214 · 10th to 90th $151 to $513
$100$200$500$1K$2Kfacility $398professional $214

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
$208.93
Median
$398.11
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$208.93
Typical High
$467.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$891.25
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$537.03
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

Where Illinois sits

The same service costs 3.0 times more in Alaska than in Maryland. 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· 23rd of 51

$257

AK $575MD $191

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.