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Prostate Cancer Urine Gene Score

Kentucky 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?

$200

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $257 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$200$200 to $209
FacilityA hospital or hospital-owned outpatient department$257$209 to $380

How much rates vary

Facilitymedian $257 · 10th to 90th $200 to $617Professionalmedian $200 · 10th to 90th $151 to $295
$100$200$500$1Kfacility $257professional $200

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
$199.53
Median
$208.93
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$309.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$199.53
Typical High
$199.53
CareSource
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$489.78
CareSource
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$331.13
Typical High
$416.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$1,230.27
Typical High
$1,230.27
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$257.04
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$151.36
Typical High
$257.04

Where Kentucky 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.

Kentucky· 49th of 51

$200

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.