To the best of my knowledge, exosomedx has not been approved by the FDA.
Your PSA level is within the normal range (<4ng/ml). Traditionally, your risk for prostate cancer is low. However, your exosomedx result is high, meaning possibility of prostate cancer. According to the information provided by the company, the test is intended for men of ≥ 50 years of age with a PSA level of between 2 and 10 ng/ml. Basically, the lower the value, the lower probability for high-grade disease on an initial biopsy.
So, basically your PSA result contradicts with your exosomedx result. Your best management should be made by your treating urologist.