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Tumor Test For Common Metabolic Gene Changes

South Dakota rates for HCPCS 81121

A laboratory test on a tumor or bone marrow sample that looks for a set of specific known changes in a gene controlling a step in the cell's energy metabolism. Only those common, well-defined changes are examined rather than the whole gene being read from end to end. Results help guide treatment choices and judge outlook in certain brain tumors and in acute myeloid leukemia.

Rates data updated July 2026.

How much does Tumor Test For Common Metabolic Gene Changes cost?

$447

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $562 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$389$229 to $692
FacilityA hospital or hospital-owned outpatient department$562$537 to $562

How much rates vary

Facilitymedian $562 · 10th to 90th $331 to $562Professionalmedian $389 · 10th to 90th $200 to $708
$200$500facility $562professional $389

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
$208.93
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$229.09
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$562.34
Typical High
$707.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$537.03
Medica
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$1,479.11
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$691.83
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$177.83
Typical High
$389.05
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12

Where South Dakota sits

The same service costs 3.3 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.

South Dakota· 4th of 51

$447

AK $661DE $200

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.