go back

Prostate Cancer Urine Gene Score

Massachusetts 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 Massachusetts, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $257 from a physician practice, and about $501 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 8 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$257$200 to $257
FacilityA hospital or hospital-owned outpatient department$501$347 to $692

How much rates vary

Facilitymedian $501 · 10th to 90th $200 to $832Professionalmedian $257 · 10th to 90th $151 to $631
$100$200$500$1K$2Kfacility $501professional $257

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
$512.86
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$758.58
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$831.76
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$741.31
BCBS
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$501.19
Typical High
$724.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$309.03
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$275.42
Typical High
$660.69
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$371.54
Typical High
$436.52
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$467.74
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$831.76
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$239.88
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$575.44

Where Massachusetts 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.

Massachusetts· 19th 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.