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Prostate Cancer Urine Gene Score

West 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?

$209

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $316 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$204$191 to $219
FacilityA hospital or hospital-owned outpatient department$316$209 to $380

How much rates vary

Facilitymedian $316 · 10th to 90th $209 to $501Professionalmedian $204 · 10th to 90th $170 to $219
$100$200$500$1Kfacility $316professional $204

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
$208.93
Median
$316.23
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$218.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
CareSource
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$630.96
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$1,230.27
Typical High
$1,230.27
United
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$114.82
Typical High
$257.04

Where West 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.

West Virginia· 38th of 51

$209

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.