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BRCA1 Gene Analysis

North Carolina rates for HCPCS 81166

A laboratory test that examines the BRCA1 gene, in which inherited changes raise the risk of breast and ovarian cancer. It is generally run on a blood or saliva sample and is ordered when a personal or family history points to a cancer risk running in the family.

Rates data updated July 2026.

How much does BRCA1 Gene Analysis cost?

$240

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $269 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$240$200 to $309
FacilityA hospital or hospital-owned outpatient department$269$240 to $501

How much rates vary

Facilitymedian $269 · 10th to 90th $229 to $1,000Professionalmedian $240 · 10th to 90th $141 to $427
$200$500$1Kfacility $269professional $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
$190.55
Median
$263.03
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$239.88
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$912.01
Typical High
$912.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$269.15
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$660.69
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$144.54
Typical High
$457.09
Medcost
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$457.09
Medcost
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$354.81
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$316.23
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$2,238.72

Where North Carolina sits

The same service costs 3.3 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.

North Carolina· 45th of 51

$240

AK $676DE $204

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.