@kingsnake I had 3 trans rectal biopsy's prior to going to Mayo for the MRI Assisted biopsy. The first 3 came back with no cancer found, taking only 8 samples on one and 12 on the remaining 2. This is all with my PSA continuing to increase. Once I decided to give Mayo a shot, they suggested the MRI assisted biopsy that I agreed to. They took 18 samples and did find the cancer. If your insurance would pay for it, why would you not go to Mayo since it's ranked in the top 3 hospitals in the country for cancer treatment. In your post you didn't list Mayo Rochester, is there a reason for that? Best of luck.
Dave

My odyssey started here in Omaha, where I had both my MRI and 16-core Transrectal Fusion Biopsy. After my results (Gleason 4+3=7, Intermediate/Localized) on 7/11/2022, I really thought I'd go with surgery, but I thought I should evaluate radiation, too. My doctor's clinic no longer had a radiology oncologist, so I'd have to visit a third institution for that evaluation. That's when I listened to the "inner voice" and contacted Mayo Rochester. They worked miracles with my nephew and his cancer, so I thought I'd be foolish not to go (only 6 hrs for me). Kingsnake, I don't know what you have to work with in CO, but the sheer organization and professionalism at Mayo brings peace of mind. I saw a surgeon on a Monday and, thanks to a cancellation, a radiology oncologist on Wednesday. That was serendipitous, so I wouldn't hold it as standard, but it showed that Mayo does try to work with you and your situation. I won't go into detail about my road to making a choice (I don't want Colleen to have to move my comment elsewhere), so I'll say only that I start The Process for radiation on Oct 13.

Good Luck, Kingsnake. There be a wealth of information in these many comments. Take your time and don't get overwhelmed.

Hello, I can relate to your concerns. I live in Wyoming and had a traditional 12-core grid biopsy. The results were sent to a lab in Loveland, Colorado. Six samples showed Gleason scores of 6 and 7. (Two were 7. ) My doctor recommended surgery for me. I’d wanted a second opinion. I contacted the Mayo Clinic in Phoenix. They requested my results from the lab. I then had a Zoom appointment and discussed my options. After talking with two different Mayo doctors, my treatments idea switched from radiation to surgery. It took a while to get my surgery done because of COVID-19 concerns at the Mayo Clinic. I had an MRI at the Mayo Clinic the day before my surgery. My surgery went well; I went home to recuperate the same day.
Good luck with your decision. I know every situation is different. Jerry