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Dystrophin Gene Deletion And Duplication Test

West Virginia 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 West Virginia, 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 $347 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 4 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$186 to $240
FacilityA hospital or hospital-owned outpatient department$347$229 to $417

How much rates vary

Facilitymedian $347 · 10th to 90th $229 to $537Professionalmedian $224 · 10th to 90th $186 to $240
$100$200$500$1Kfacility $347professional $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
$346.74
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$223.87
Typical High
$239.88
CareSource
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$537.03
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$1,348.96
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$117.49
Typical High
$213.80

Where West Virginia 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.

West Virginia· 46th 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.