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Dystrophin Gene Deletion And Duplication Test

North Carolina 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?

$224

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $224 for this service. The price depends on where it is billed: about $224 from a physician practice, and about $245 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$224$126 to $251
FacilityA hospital or hospital-owned outpatient department$245$224 to $427

How much rates vary

Facilitymedian $245 · 10th to 90th $174 to $933Professionalmedian $224 · 10th to 90th $63 to $347
$100$200$500$1Kfacility $245professional $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
$173.78
Median
$245.47
Typical High
$933.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$223.87
Typical High
$371.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$630.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$125.89
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$616.60
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$131.83
Typical High
$371.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$281.84
Typical High
$630.96
Medcost
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$169.82
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$138.04
Typical High
$234.42
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$2,089.30

Where North Carolina 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.

North Carolina· 43rd of 51

$224

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.