go back

Prostate Cancer Risk Blood Score

New York 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?

$692

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $692 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $1,148 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 9 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$331 to $851
FacilityA hospital or hospital-owned outpatient department$1,148$759 to $1,738

How much rates vary

Facilitymedian $1,148 · 10th to 90th $589 to $2,089Professionalmedian $603 · 10th to 90th $302 to $1,380
$500$1K$2K$5Kfacility $1,148professional $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
$537.03
Median
$1,258.93
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$616.60
Typical High
$1,380.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,995.26
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$1,318.26
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$758.58
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$758.58
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,621.81
Typical High
$2,187.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$812.83
Typical High
$3,235.94
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$977.24
Typical High
$2,089.30
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$645.65
Typical High
$1,445.44
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$724.44
Typical High
$1,348.96
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$977.24
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$758.58
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$758.58
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$537.03
Typical High
$1,698.24
Univera
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$691.83
Typical High
$812.83
Univera
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$724.44
Typical High
$1,819.70

Where New York 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.

New York· 29th of 51

$692

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.