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Dystrophin Gene Analysis For Muscular Dystrophy

Maine rates for HCPCS 0218U

Looks for changes in the DMD gene, the cause of Duchenne and Becker muscular dystrophy, in someone with muscle weakness that may be inherited. This single gene is read in full, including stretches that are difficult to read accurately, and both missing and duplicated sections of the gene are detected. Blood or saliva can be used.

Rates data updated July 2026.

How much does Dystrophin Gene Analysis For Muscular Dystrophy cost?

$2,291

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $2,291 for this service. The price depends on where it is billed: about $2,291 from a physician practice, and about $3,715 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$2,291$1,862 to $2,291
FacilityA hospital or hospital-owned outpatient department$3,715$2,291 to $11,749

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,291 to $14,454Professionalmedian $2,291 · 10th to 90th $1,318 to $2,291
$1K$2K$5K$10Kfacility $3,715professional $2,291

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
$2,290.87
Median
$2,290.87
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$1,862.09
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$14,454.40
Typical High
$15,848.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,318.26
Typical High
$2,187.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,754.23
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$5,754.40
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$2,290.87
United
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,290.87
Typical High
$3,388.44

Where Maine sits

The same service costs 6.5 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.

Maine· 21st of 51

$2,291

AK $5,129KY $794

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.