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Prostate Cancer Urine Gene Score

Ohio 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?

$219

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $347 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$204$132 to $240
FacilityA hospital or hospital-owned outpatient department$347$257 to $562

How much rates vary

Facilitymedian $347 · 10th to 90th $209 to $617Professionalmedian $204 · 10th to 90th $102 to $437
$100.0$200.0$500.0$1.0Kfacility $347professional $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
$204.17
Median
$457.09
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$269.15
Typical High
$467.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$346.74
CareSource
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
CareSource
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$338.84
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$512.86
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$338.84
Typical High
$1,412.54
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$138.04
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$229.09
Typical High
$275.42
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$281.84
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$257.04
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$141.25
Typical High
$354.81

Where Ohio sits

The same service costs 3.0 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Ohio $219 · 33rd of 51
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.