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Prostate Tumor Gene Activity Score

West Virginia rates for HCPCS 81541

A laboratory test run on prostate tumor tissue that measures how active a set of genes is in the cancer cells and turns the readings into a score reflecting how aggressively the tumor is likely to behave. The score is used alongside the biopsy findings and blood results when choosing between monitoring, surgery, or radiation. It uses tissue already taken at biopsy or surgery, so no extra procedure is needed.

Rates data updated July 2026.

How much does Prostate Tumor Gene Activity Score cost?

$3,162

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $3,162 for this service. The price depends on where it is billed: about $3,090 from a physician practice, and about $4,786 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$3,090$2,884 to $3,311
FacilityA hospital or hospital-owned outpatient department$4,786$3,162 to $5,754

How much rates vary

Facilitymedian $4,786 · 10th to 90th $3,162 to $5,754Professionalmedian $3,090 · 10th to 90th $2,570 to $3,311
$2K$5K$10Kfacility $4,786professional $3,090

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
$3,162.28
Median
$4,786.30
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,090.30
Typical High
$3,311.31
CareSource
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$5,248.07
CareSource
Setting
Professional
Modifier
Global
Typical Low
$4,677.35
Median
$4,677.35
Typical High
$4,677.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$5,623.41
Typical High
$11,748.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$18,620.87
Typical High
$18,620.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$4,466.84
United
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,949.84
Typical High
$4,265.80

Where West Virginia sits

The same service costs 3.4 times more in Alaska than in Delaware. 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· 40th of 51

$3,162

AK $8,710DE $2,570

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.