go back

Prostate Cancer Urine Gene Score

New Jersey 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 New Jersey, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $813 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$191 to $214
FacilityA hospital or hospital-owned outpatient department$813$324 to $1,820

How much rates vary

Facilitymedian $813 · 10th to 90th $234 to $9,550Professionalmedian $200 · 10th to 90th $141 to $295
$100$500$2K$10Kfacility $813professional $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
$323.59
Median
$831.76
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$562.34
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$275.42
Typical High
$537.03
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$489.78
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$257.04
Typical High
$524.81
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$151.36
Typical High
$263.03

Where New Jersey 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.

New Jersey· 44th 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.