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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.

Facilitymedian $692 · 10th–90th $214$1,1220%10%10th90th$692Professionalmedian $204 · 10th–90th $158$5750%20%40%10th90th$204$100.0$500.0$2.0K$10.0K$50.0K

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
$213.80
Median
$691.83
Typical High
$1,122.02
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$758.58
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,258.93
Typical High
$5,011.87
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
$229.09
Typical High
$346.74
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
$389.05
Typical High
$912.01
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$204.17
Typical High
$309.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$288.40
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$309.03
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$257.04
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$331.13