@ezupcic Unfavorable Intermediate would be if 50% or more was type 4; yours is only 10%. Decipher should be covered since it is used for AS vs treatment decisions. Just say you want to see these results before a decision. Most insurance will not cover PSMA PET for 3+4. If you have Medicare (not Advantage) it should be covered. The pathology report did not indicate any aggressive features. At 3+4 you can have surgery or radiation (SBRT, IMRT, LDR, or HDR) so lots of treatment options. If ADT suggested get ArteraAI test to determine if you will benefit.
Your two 3+4 cores are on opposite sides of the prostate. This and all of the Gleason 6 make you a poor candidate for focal therapy. Except for Medicare, most insurance will not cover focal treatment.
You can get a second opinion of the pathology, but will this be useful? Do you believe the 10% of 4 in the 3+4s should be downgraded to 3 for AS and with all the 3+3 cores is AS advisable? Not likely another pathologist will find that 40% was misclassified as 3 when it should have been 4 for an upgrade to 4+3.