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Prostate Cancer Urine Gene Score

Pennsylvania 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 Pennsylvania, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $209 from a physician practice, and about $427 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$209$200 to $240
FacilityA hospital or hospital-owned outpatient department$427$269 to $759

How much rates vary

Facilitymedian $427 · 10th to 90th $219 to $1,096Professionalmedian $209 · 10th to 90th $141 to $603
$100$200$500$1Kfacility $427professional $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
$426.58
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$208.93
Typical High
$912.01
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,288.25
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$416.87
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$275.42
Typical High
$575.44
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$331.13
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$426.58
Typical High
$645.65
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$537.03
Typical High
$912.01
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$208.93
Typical High
$912.01
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$630.96
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$257.04
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$354.81

Where Pennsylvania 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.

Pennsylvania· 34th of 51

$219

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.