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Dystrophin Gene Deletion And Duplication Test

Kentucky 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?

$219

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $282 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$135$107 to $229
FacilityA hospital or hospital-owned outpatient department$282$229 to $525

How much rates vary

Facilitymedian $282 · 10th to 90th $229 to $676Professionalmedian $135 · 10th to 90th $107 to $363
$100$200$500$1Kfacility $282professional $135

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
$229.09
Typical High
$676.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$380.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$281.84
Typical High
$295.12
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$112.20
CareSource
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$524.81
CareSource
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$363.08
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$537.03
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$1,348.96
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$125.89
Typical High
$223.87

Where Kentucky 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.

Kentucky· 47th of 51

$219

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.