CPT 81313 Pathology/Laboratory

How Much Does Test for detecting genes associated with prostate cancer Cost?

Test for detecting genes associated with prostate cancer (CPT 81313) costs $255 at Medicare rates.

Medicare (Facility)
$255
CMS PFS 2026 national rate

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How to Reduce Your Cost for Test for detecting genes associated with prostate cancer

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

Frequently Asked Questions

How much does Test for detecting genes associated with prostate cancer cost?

The Medicare facility rate for Test for detecting genes associated with prostate cancer is $255. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Test for detecting genes associated with prostate cancer cost without insurance?

Without insurance, the cost of Test for detecting genes associated with prostate cancer can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Test for detecting genes associated with prostate cancer?

Most commercial health insurance plans and Medicare cover Test for detecting genes associated with prostate cancer when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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