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Genetic Test For Medication Response

Illinois rates for HCPCS 0031U

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?

$174

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $209 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 4 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$151$95.50 to $245
FacilityA hospital or hospital-owned outpatient department$209$174 to $234

How much rates vary

Facilitymedian $209 · 10th to 90th $174 to $302Professionalmedian $151 · 10th to 90th $74 to $309
$100$200$500facility $209professional $151

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
BCBS
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$234.42
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$213.80
Typical High
$257.04
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$104.71
Typical High
$173.78

Where Illinois sits

The same service costs 6.8 times more in Alaska than in Kentucky. 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.

Illinois· 19th of 51

$174

AK $389KY $57.54

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.