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Prostate Cancer Risk Blood Score

North Carolina rates for HCPCS 81539

A blood test that measures several prostate-related proteins and combines them through a formula into a single score estimating the chance that aggressive prostate cancer is present. It is used when a raised routine prostate blood result has been found, to help decide whether a biopsy is warranted. It gives a probability rather than a yes-or-no answer.

Rates data updated July 2026.

How much does Prostate Cancer Risk Blood Score cost?

$603

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $676 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$603$550 to $759
FacilityA hospital or hospital-owned outpatient department$676$603 to $1,000

How much rates vary

Facilitymedian $676 · 10th to 90th $513 to $2,399Professionalmedian $603 · 10th to 90th $457 to $1,072
$500$1K$2Kfacility $676professional $603

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
$478.63
Median
$676.08
Typical High
$2,398.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$602.56
Typical High
$1,000.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,513.56
Typical High
$1,862.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$758.58
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$1,659.59
Typical High
$3,467.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$1,023.29
Medcost
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$691.83
Typical High
$1,174.90
Medcost
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$724.44
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$457.09
Typical High
$776.25
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$3,630.78
Typical High
$3,630.78
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$5,754.40

Where North Carolina sits

The same service costs 3.8 times more in Alaska than in Rhode Island. 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.

North Carolina· 45th of 51

$603

AK $1,698RI $447

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.