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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 October 2026.

How much does Prostate Cancer Urine Gene Score cost?

$204

Typical negotiated rate. In Ohio, October 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $316 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$129$102 to $229
FacilityA hospital or hospital-owned outpatient department$316$263 to $437

How much rates vary

Facilitymedian $316 · 10th to 90th $229 to $617Professionalmedian $129 · 10th to 90th $102 to $407
$100$200$500$1Kfacility $316professional $129

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$457.09
Typical High
$645.65
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$120.23
Median
$229.09
Typical High
$323.59
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$47.86
Median
$91.20
Typical High
$128.82
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$630.96
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$102.33
Median
$102.33
Typical High
$316.23
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$40.74
Median
$40.74
Typical High
$125.89
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$208.93
Median
$295.12
Typical High
$467.74
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$354.81
CareSource
Setting
Professional
Modifier
None
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Cigna
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$309.03
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$117.49
Typical High
$371.54
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$316.23
Typical High
$1,047.13
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$117.49
Typical High
$457.09
Molina
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$229.09
Typical High
$316.23
SummaCare
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$316.23
Typical High
$407.38
United
Setting
Facility
Modifier
None
Typical Low
$91.20
Median
$229.09
Typical High
$380.19
United
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$151.36
Typical High
$363.08

Where Ohio sits

The same service costs 5.2 times more in Texas than in New Mexico. 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.

Ohio· 36th of 51

$204

TX $794NM $151

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.