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Genetic Test For Medication Response

Pennsylvania rates for HCPCS 0030U

A genetic test that looks at inherited differences affecting how a person's body handles or responds to medicines. The findings help the prescriber pick a drug and a dose more likely to work well and less likely to cause side effects.

Rates data updated July 2026.

How much does Genetic Test For Medication Response cost?

$115

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $115 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $257 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$110$81.28 to $115
FacilityA hospital or hospital-owned outpatient department$257$162 to $339

How much rates vary

Facilitymedian $257 · 10th to 90th $115 to $479Professionalmedian $110 · 10th to 90th $72 to $135
$100$200$500facility $257professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$257.04
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$109.65
Typical High
$125.89
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$181.97
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$190.55
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$223.87
Typical High
$338.84
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$281.84
Typical High
$478.63
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$109.65
Typical High
$398.11
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$134.90
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$81.28
Typical High
$177.83

Where Pennsylvania sits

The same service costs 3.4 times more in Alaska than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 38th of 51

$115

AK $302AL $89.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.