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Prostate Cancer Urine Gene Score

North Carolina 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?

$204

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $224 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 6 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$204$141 to $257
FacilityA hospital or hospital-owned outpatient department$224$204 to $380

How much rates vary

Facilitymedian $224 · 10th to 90th $200 to $851Professionalmedian $204 · 10th to 90th $115 to $339
$100$200$500$1Kfacility $224professional $204

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
$162.18
Median
$223.87
Typical High
$851.14
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$338.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$645.65
Typical High
$812.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$117.49
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$562.34
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$169.82
Typical High
$346.74
Medcost
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$239.88
Typical High
$398.11
Medcost
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$239.88
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$151.36
Typical High
$263.03
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,905.46

Where North Carolina 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.

North Carolina· 40th of 51

$204

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.