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Dystrophin Gene Deletion And Duplication Test

New Jersey 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?

$355

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $891 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$240$204 to $832
FacilityA hospital or hospital-owned outpatient department$891$355 to $1,660

How much rates vary

Facilitymedian $891 · 10th to 90th $257 to $5,888Professionalmedian $240 · 10th to 90th $93 to $832
$100$500$2K$10Kfacility $891professional $240

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
$354.81
Median
$1,096.48
Typical High
$2,630.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$239.88
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$616.60
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$269.15
Typical High
$616.60
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$524.81
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$11,481.54
Typical High
$25,118.86
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$281.84
Typical High
$575.44
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$158.49
Typical High
$257.04

Where New Jersey 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.

New Jersey· 7th of 51

$355

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.