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Prostate Cancer Test Cost


How Much Does a Prostate Cancer Test Cost?

 
average costWith Health Insurance: $0-$30 Copayshigh costWithout Health Insurance: $15-$6,000+
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  Typical costs:
  • For patients covered by health insurance, out-of-pocket costs for a prostate cancer test typically consist of a doctor-visit copay and a laboratory copay of $0-$30 or more, depending on the plan. For routine wellness screenings, some insurance plans consider the tests medically necessary only after a certain age. For example, Aetna[1] covers screenings for men 40 and over, and men under 40 who are at a high risk, such as African-American men with a family history of prostate cancer.
  • For patients not covered by health insurance, a prostate cancer test typically costs from less than $15-$250 for a digital rectal exam to detect any physical abnormalities in the prostate, depending on the provider and whether the exam is done on its own or as part of an office visit. And it can cost up to $6,000 or more for a prostate biopsy. For example, several cancer centers[2] in Michigan offer prostate exams for $15-$20. Talbert Medical[3] in California, charges about $60. And Robert Gluck, M.D[4] , a urologist in New York, charges $250 for an office visit that includes a digital prostate exam.
  • A prostate-specific antigen test, which can detect increased levels of a protein produced by the prostate gland, typically costs $20-$50 for an at-home test or up to $120 or more if performed at a hospital. And a prostate biopsy should cost about $460 in a doctor's office or $1,500 in an ambulatory surgery center, according to health care pricing website HealthcareBlueBook.com[5] . However, patients on a forum at HealingWell.com[6] report costs ranging from $1,500 to more than $6,000.
Related articles: PSA Test, Blood Tests, Health Insurance

What should be included:
  • In a digital prostate exam[7] , the doctor puts on gloves, applies a lubricant, and inserts a finger into the rectum to feel for abnormalities. The test takes a few minutes and the patient can resume normal activities immediately.
  • In a prostate-specific antigen test, blood is drawn from the patient and sent to a laboratory to be tested to see if PSA levels are abnormally high, which could indicate prostate cancer.
  • In a prostate biopsy[8] , local anesthesia with sedative or general anesthesia can be used. The doctor -- usually using ultrasound to guide the process -- inserts a needle through the rectum, urethra or perineum to obtain a sample of prostate tissue, which is sent to a laboratory for analysis. It usually takes a week to 10 days for the doctor to get the results.
  • WebMD offers an overview of prostate cancer tests[9] .
Additional costs:
  • Antibiotics, such as ciprofloxacin or levofloxacin, might be required before or after a prostate biopsy, and typically cost less than $20.
Discounts:
  • Many cancer centers, health fairs and other providers offer free or discounted prostate exams and screening. For example, ZeroCancer.org[10] offers prostate cancer screening in communities across the United States.
  • The U.S. Department of Health and Human Services offers a locator[11] for clinics that provide discounts on an income-based sliding scale.
  • Many doctors and hospitals give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[12] in California offers a 35% discount.
Shopping for a prostate cancer test:
  • A prostate exam and PSA test can be done by a primary care physician or urologist. WebMD offers a doctor locator[13] by zip code. And the American Urological Association offers a urologist locator[14] .
  • For patients who want anonymity or do not wish to go through a doctor, companies such as LabCorp[15] , Quest Diagnostics[16] and Health Testing Centers[17] offer PSA testing direct to patients. However, it is important to seek the advice of a doctor for any health concerns.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
 
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What People Are Paying - Recent Comments
Prostate Cancer Costs
Amount: $0.00
Posted by: David Pca in Kitchener, Other.Posted: March 31st, 2021 09:03AM
Test: PSAx3, Biopsy, CT ScanProvider: St Joe’s Hamilton, Grand River Cancer C
Insurance Carrier: Ontario Government
Robotic Surgery, one night at the hospital, numerous Dr spots, PET scan, Rad Onc consult, radiation therapy... never had a decision to make about treatments with respect to cost, waiting time was minimal. Thank god for universal Jealth care.
Was this post helpful to you?   yes     no Report prohibited or spam
Prostate Biopsy
Amount: $1,716.13
Posted by: CaryS in Galax, VA.Posted: April 16th, 2020 06:04PM
Test: Prostate BiopsyProvider: Twin County
Insurance Carrier: Anthem
Could not shop cost comparison in advance because Anthem Engage tool has no information on the cost for this procedure, despite being done a million times annually in the USA. Anthem stated this is because their network providers are not provided the cost information. If true, why isn't Anthem requiring this information to help their members? Anthem processes the claims, how can they say they don't have the information?
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Low Cost 3T MP MRI
Amount: $695.00
Posted by: Jay S in Sarasota, FL.Posted: May 12th, 2017 02:05PM
Test: 3T MP MRIProvider: Partners Imaging
Insurance Carrier: Self-paid
This facility uses the latest 3T equipment with results read by Dr. Goldberg, a top radiologist. We got the report and a CD of the images 2 hours after the test. Cost was about half that quoted elsewhere. Also, they do not use an endorectal coil, making the test less burdensome.
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ray spillers
Amount: $0.00
Posted by: Raymond Spillers in Sugar Land, TX.Posted: April 24th, 2017 06:04PM
Test: prostate biopsyProvider:
Insurance Carrier: medicare AARP, united health care
need to know cost of prostrate biopsy
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Prostate Biopsy
Amount: $11,784.00
Posted by: Dennis Stott in Bloomington, IL.Posted: April 30th, 2016 11:04AM
Test: Diagnostic PathologyProvider: Premier Medical Group LLC
Insurance Carrier: BCBS
Doctors Office $1,500 for Biopsy. My cost $121
DIAGNOSTIC PATHOLOGY 12 items for $482. 15 items for $400. Total for Diagnostic Pathology? $11,784. As of 4/30 insurance has not acted on this. SEEMS EXCESSIVE?
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Prostate biopsy
Amount: $3,319.60
Posted by: a user in Berkeley,, CA.Posted: January 11th, 2015 01:01PM
Test: prostate biopsy, needle or punchProvider: Orion
Insurance Carrier: United Health
The procedure was performed in the doctor's office. The doctor's fees after insurance adjustments were 823.60; pathology costs was 2496. We pay 1500 per month for this coverage. I often wonder why.
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prostate specific antigen (PSA)
Amount: $137.00
Posted by: BEN1900 in HIALEAH, FL.Posted: November 19th, 2012 08:11AM
Test: PSAProvider: QUEST
Insurance Carrier: AETNA
AETNA DID NOT COVER FOR THE PSA FOR MEN AT THE AGE OF 49 STATING THAT THEY WILL COVER ONLY FOR THOSE ABOVE 50..SO THE TOTAL AMOUNT IS THE PATIENT RESPONSIBILITY.
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External Resources:
  1.  www.aetna.com/cpb/medical/data/500_599/0521.html
  2.  www.prostatecancermichigan.org/Tab%20Detection/ScreeningsPCAC-MI.html
  3.  www.healthcarepartners.com
  4.  www.faircaremd.com/public/offers/urology-office-visit-for-new-patients-with-comple...
  5.  healthcarebluebook.com/page_Results.aspx?id=92&dataset=MD
  6.  www.healingwell.com/community/default.aspx?f=35&m=1949852
  7.  www.webmd.com/prostate-cancer/guide/prostate-cancer-digital-rectal-exam
  8.  men.webmd.com/prostate-biopsy
  9.  www.webmd.com/prostate-cancer/guide/understanding-prostate-cancer-treatment
  10.  zerocancer.org/events/free-testing/
  11.  findahealthcenter.hrsa.gov/Search_HCC.aspx
  12.  www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
  13.  doctor.webmd.com/home.aspx?sponsor=core
  14.  www.urologyhealth.org/urology/findurologist.cfm
  15.  /www.labcorp.com/wps/portal/findalab/
  16.  www.questdiagnostics.com/home.html
  17.  www.healthtestingcenters.com
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