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Genetic Test For Medication Response

Massachusetts 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 Massachusetts, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $219 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 7 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$166$105 to $200
FacilityA hospital or hospital-owned outpatient department$219$174 to $295

How much rates vary

Facilitymedian $219 · 10th to 90th $174 to $437Professionalmedian $166 · 10th to 90th $105 to $513
$100$200$500$1K$2K$5Kfacility $219professional $166

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
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$870.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$316.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$269.15
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$4,897.79
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$295.12
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$104.71
Typical High
$309.03
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$398.11

Where Massachusetts 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.

Massachusetts· 24th 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.