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Circulating Tumor DNA Panel Of 55 To 74 Genes

Pennsylvania rates for HCPCS 0242U

Profiles a solid tumor by examining cell-free tumor DNA — fragments the tumor sheds into the circulation — instead of a piece of the tumor itself. It is a mid-sized panel covering between 55 and 74 genes.

Rates data updated July 2026.

How much does Circulating Tumor DNA Panel Of 55 To 74 Genes cost?

$4,266

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $4,266 for this service. The price depends on where it is billed: about $4,074 from a physician practice, and about $9,550 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$4,074$3,020 to $4,266
FacilityA hospital or hospital-owned outpatient department$9,550$6,026 to $12,589

How much rates vary

Facilitymedian $9,550 · 10th to 90th $4,266 to $17,783Professionalmedian $4,074 · 10th to 90th $2,754 to $5,012
$2K$5K$10K$20Kfacility $9,550professional $4,074

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
$4,265.80
Median
$9,549.93
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$4,073.80
Typical High
$4,677.35
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,630.78
Median
$7,585.78
Typical High
$16,982.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23,988.33
Median
$23,988.33
Typical High
$23,988.33
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$6,606.93
Median
$6,606.93
Typical High
$7,079.46
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$5,754.40
Typical High
$9,332.54
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$10,471.29
Typical High
$17,782.79
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2,754.23
Median
$4,073.80
Typical High
$14,791.08
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,495.41
Typical High
$12,302.69
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,495.41
United
Setting
Facility
Modifier
Global
Typical Low
$4,466.84
Median
$5,011.87
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$3,019.95
Typical High
$6,606.93

Where Pennsylvania sits

The same service costs 3.4 times more in Alaska than in Nebraska. 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· 36th of 51

$4,266

AK $11,220NE $3,311

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.