go back

Prostate Cancer Urine Gene Score

Tennessee 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 Tennessee, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $457 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 5 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 $257
FacilityA hospital or hospital-owned outpatient department$457$234 to $851

How much rates vary

Facilitymedian $457 · 10th to 90th $191 to $1,096Professionalmedian $200 · 10th to 90th $135 to $309
$100$200$500$1Kfacility $457professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$691.83
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$199.53
Typical High
$295.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$257.04
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$537.03
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$147.91
Typical High
$354.81
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,288.25
Median
$1,905.46
Typical High
$1,905.46
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$257.04
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$128.82
Typical High
$263.03

Where Tennessee 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.

Tennessee· 35th 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.