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Dystrophin Gene Deletion And Duplication Test

Pennsylvania 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?

$263

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $263 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $589 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 9 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$229$219 to $324
FacilityA hospital or hospital-owned outpatient department$589$331 to $832

How much rates vary

Facilitymedian $589 · 10th to 90th $240 to $1,698Professionalmedian $229 · 10th to 90th $85 to $832
$100$200$500$1K$2Kfacility $589professional $229

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
$239.88
Median
$588.84
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$229.09
Typical High
$1,000.00
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$457.09
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$263.03
Typical High
$630.96
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$363.08
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$467.74
Typical High
$707.95
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$645.65
Typical High
$1,621.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$234.42
Typical High
$1,000.00
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$1,348.96
Typical High
$2,818.38
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$281.84
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$165.96
Typical High
$371.54

Where Pennsylvania 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.

Pennsylvania· 33rd of 51

$263

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.