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Whole Genome Sequencing For Rare Inherited Disease

Maine rates for HCPCS 0212U

Searches for the genetic cause of a suspected rare inherited disorder in the affected patient. The person's entire genome is sequenced, together with mitochondrial DNA, and anything found is classified by how likely it is to be causing disease. Blood or saliva can be used.

Rates data updated July 2026.

How much does Whole Genome Sequencing For Rare Inherited Disease cost?

$5,495

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $5,495 for this service. The price depends on where it is billed: about $5,495 from a physician practice, and about $5,495 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 6 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$5,495$3,090 to $5,495
FacilityA hospital or hospital-owned outpatient department$5,495$5,495 to $12,303

How much rates vary

Facilitymedian $5,495 · 10th to 90th $5,495 to $13,804Professionalmedian $5,495 · 10th to 90th $589 to $5,495
$100$500$2K$10Kfacility $5,495professional $5,495

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
$5,495.41
Median
$5,495.41
Typical High
$13,803.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$2,951.21
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$2,454.71
Typical High
$3,548.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12,302.69
Median
$12,302.69
Typical High
$12,302.69
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$6,606.93
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$5,495.41
Typical High
$13,803.84
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$5,495.41
United
Setting
Professional
Modifier
Global
Typical Low
$3,311.31
Median
$5,495.41
Typical High
$7,943.28

Where Maine sits

The same service costs 4.3 times more in Alaska than in Delaware. 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.

Maine· 13th of 51

$5,495

AK $12,303DE $2,884

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.