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BRCA1 And BRCA2 Gene Analysis

Pennsylvania rates for HCPCS 81164

A laboratory test that examines the BRCA1 and BRCA2 genes, in which changes are strongly linked to an inherited risk of breast, ovarian, prostate and pancreatic cancer. It is usually run on a blood or saliva sample and is ordered when a personal or family history suggests that a cancer risk runs in the family. Results help guide screening and prevention decisions, and sometimes testing of relatives.

Rates data updated July 2026.

How much does BRCA1 And BRCA2 Gene Analysis cost?

$501

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $1,122 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 8 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$479$380 to $550
FacilityA hospital or hospital-owned outpatient department$1,122$708 to $1,738

How much rates vary

Facilitymedian $1,122 · 10th to 90th $501 to $2,570Professionalmedian $479 · 10th to 90th $316 to $1,288
$500$1K$2Kfacility $1,122professional $479

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
$501.19
Median
$1,122.02
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$2,089.30
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,884.03
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$954.99
Typical High
$1,995.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$501.19
Typical High
$1,023.29
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$758.58
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$707.95
Typical High
$1,096.48
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,122.02
Typical High
$2,089.30
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$2,089.30
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,995.26
Typical High
$3,630.78
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$602.56
Typical High
$645.65
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$588.84
Typical High
$707.95
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$346.74
Typical High
$870.96

Where Pennsylvania sits

The same service costs 3.4 times more in Alaska than in Delaware. 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· 35th of 51

$501

AK $1,318DE $389

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.