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Prostate Cancer Urine Gene Score

New York 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.

Facilitymedian $447 · 10th–90th $219$7760%10%20%10th90th$447Professionalmedian $209 · 10th–90th $102$4790%20%10th90th$209$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$457.09
Typical High
$776.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$213.80
Typical High
$478.63
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$660.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$446.68
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$257.04
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$257.04
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$549.54
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$331.13
Typical High
$1,230.27
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$331.13
Typical High
$707.95
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$229.09
Typical High
$478.63
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$239.88
Typical High
$457.09
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$478.63
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$213.80
Typical High
$537.03
Univera
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$269.15
Typical High
$269.15
Univera
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$251.19
Typical High
$676.08