go back

BCR-ABL1 Major Breakpoint Measurement

Pennsylvania rates for HCPCS 0040U

Used in chronic myeloid leukemia to measure how much of the abnormal BCR-ABL1 gene fusion is present, which shows how the disease is responding. It reports a quantity for the major breakpoint form of the fusion only; a companion test covers both breakpoint forms.

Rates data updated July 2026.

How much does BCR-ABL1 Major Breakpoint Measurement cost?

$389

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $275 from a physician practice, and about $871 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$275$245 to $389
FacilityA hospital or hospital-owned outpatient department$871$562 to $1,023

How much rates vary

Facilitymedian $871 · 10th to 90th $407 to $1,445Professionalmedian $275 · 10th to 90th $240 to $631
$200$500$1K$2K$5Kfacility $871professional $275

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
$562.34
Median
$870.96
Typical High
$1,445.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$275.42
Typical High
$389.05
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
$316.23
Median
$316.23
Typical High
$316.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$660.69
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$588.84
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$489.78
Typical High
$851.14
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$870.96
Typical High
$1,445.44
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$275.42
Typical High
$1,023.29
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$501.19
Typical High
$1,023.29
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$416.87
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$407.38
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$562.34

Where Pennsylvania sits

The same service costs 11.2 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.

Pennsylvania· 39th of 51

$389

AK $912KY $81.28

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.