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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.

Rates data updated July 2026.

How much does Prostate Cancer Urine Gene Score cost?

$251

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $417 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 9 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$209$141 to $295
FacilityA hospital or hospital-owned outpatient department$417$257 to $589

How much rates vary

Facilitymedian $417 · 10th to 90th $209 to $708Professionalmedian $209 · 10th to 90th $102 to $468
$100$200$500$1Kfacility $417professional $209

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
$208.93
Median
$446.68
Typical High
$707.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$457.09
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
$724.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$346.74
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
$151.36
Median
$213.80
Typical High
$489.78
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
$13.80
Median
$331.13
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$257.04
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$213.80
Typical High
$575.44
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

Where New York 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 York· 25th of 51

$251

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.