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Prostate Cancer Urine Gene Score

South Dakota 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?

$407

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $407 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $490 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 6 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$339$200 to $589
FacilityA hospital or hospital-owned outpatient department$490$468 to $490

How much rates vary

Facilitymedian $490 · 10th to 90th $288 to $490Professionalmedian $339 · 10th to 90th $170 to $617
$100$200$500facility $490professional $339

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
$177.83
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$199.53
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$489.78
Typical High
$616.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$288.40
Typical High
$794.33
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$1,288.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$588.84
Typical High
$707.95
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$338.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04

Where South Dakota 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.

South Dakota· 2nd of 51

$407

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.