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Dystrophin Gene Deletion And Duplication Test

Illinois rates for HCPCS 81161

A laboratory test on a blood sample that checks the dystrophin gene for missing or duplicated sections. Changes of this kind are the usual cause of Duchenne and Becker muscular dystrophy, muscle-weakening conditions that mainly affect boys.

Rates data updated July 2026.

How much does Dystrophin Gene Deletion And Duplication Test cost?

$229

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $229 for this service. The price depends on where it is billed: about $224 from a physician practice, and about $437 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 5 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$224$166 to $251
FacilityA hospital or hospital-owned outpatient department$437$288 to $575

How much rates vary

Facilitymedian $437 · 10th to 90th $229 to $759Professionalmedian $224 · 10th to 90th $3 to $417
$10$100$1Kfacility $437professional $224

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
$229.09
Median
$436.52
Typical High
$575.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$234.42
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$977.24
Typical High
$3,467.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$190.55
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$588.84
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$338.84
Typical High
$512.86
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$309.03
Typical High
$478.63
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$562.34
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$117.49
Typical High
$239.88

Where Illinois sits

The same service costs 4.0 times more in Vermont than in Washington, DC. 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.

Illinois· 40th of 51

$229

VT $832DC $209

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.