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Prostate Cancer Urine Gene Score

Vermont 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 Vermont, 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 $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 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$200 to $200
FacilityA hospital or hospital-owned outpatient department$295$288 to $324

How much rates vary

Facilitymedian $295 · 10th to 90th $257 to $427Professionalmedian $200 · 10th to 90th $200 to $257
$200$500facility $295professional $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
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$302.00
Typical High
$575.44
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$263.03
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$288.40
Typical High
$562.34

Where Vermont 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.

Vermont· 48th 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.