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Prostate Cancer Urine Gene Score

Rhode Island 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?

$200

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $324 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 4 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$200$191 to $200
FacilityA hospital or hospital-owned outpatient department$324$302 to $575

How much rates vary

Facilitymedian $324 · 10th to 90th $263 to $1,479Professionalmedian $200 · 10th to 90th $162 to $257
$100$200$500$1Kfacility $324professional $200

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$575.44
Typical High
$1,479.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$323.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$707.95
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$309.03
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$151.36
Typical High
$380.19

Where Rhode Island 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.

Rhode Island· 47th of 51

$200

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.