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Prostate Cancer Urine Gene Score

Virginia 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?

$229

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $229 for this service. The price depends on where it is billed: about $191 from a physician practice, and about $295 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$191$115 to $224
FacilityA hospital or hospital-owned outpatient department$295$257 to $631

How much rates vary

Facilitymedian $295 · 10th to 90th $229 to $1,148Professionalmedian $191 · 10th to 90th $102 to $501
$100$200$500$1K$2K$5K$10Kfacility $295professional $191

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
$218.78
Median
$562.34
Typical High
$1,148.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$218.78
Typical High
$630.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$1,023.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$169.82
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$776.25
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$630.96
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$158.49
Typical High
$407.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$281.84
Typical High
$354.81
Medcost
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$295.12
Typical High
$436.52
Medcost
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$537.03
Sentara
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$338.84
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$257.04
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$128.82
Typical High
$281.84

Where Virginia 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.

Virginia· 31st of 51

$229

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.