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BRCA1 Gene Analysis

Pennsylvania 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?

$257

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $245 from a physician practice, and about $575 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$245$200 to $282
FacilityA hospital or hospital-owned outpatient department$575$363 to $832

How much rates vary

Facilitymedian $575 · 10th to 90th $257 to $1,122Professionalmedian $245 · 10th to 90th $166 to $661
$200$500$1K$2Kfacility $575professional $245

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
$257.04
Median
$575.44
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$1,071.52
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,479.11
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$489.78
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$257.04
Typical High
$524.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$398.11
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$363.08
Typical High
$575.44
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$575.44
Typical High
$1,071.52
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$1,071.52
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$331.13
Typical High
$741.31
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$302.00
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$457.09

Where Pennsylvania 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.

Pennsylvania· 33rd of 51

$257

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.