Molecular tests (MT) using gene expression and/or mutational analysis have been developed to reduce the need for diagnostic surgery for indeterminate (Bethesda III/IV) thyroid nodules. Prior cost effectiveness studies have shown mixed results but none have included the recent and more comprehensive versions of the 2 commonly utilized MT. The aim of this study is to compare the cost-effectiveness of diagnostic lobectomy (DL), the Afirma Gene Sequencing Classifier (GSC), and Thyroseq® Next-Generation Sequencing version 3 (TSv3).