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Genetic Test Of One Gene

North Carolina rates for HCPCS 81185

A specialist laboratory examines the DNA of a single gene taken from a patient sample and reports any changes found in it. The result contributes to a diagnosis or to a treatment decision rather than answering the question on its own.

Rates data updated July 2026.

How much does Genetic Test Of One Gene cost?

$676

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $676 for this service. The price depends on where it is billed: about $676 from a physician practice, and about $759 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$676$562 to $871
FacilityA hospital or hospital-owned outpatient department$759$676 to $1,413

How much rates vary

Facilitymedian $759 · 10th to 90th $646 to $2,818Professionalmedian $676 · 10th to 90th $389 to $1,202
$500$1K$2Kfacility $759professional $676

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
$537.03
Median
$741.31
Typical High
$2,818.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$676.08
Typical High
$1,122.02
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$2,570.40
Typical High
$2,570.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$758.58
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$1,862.09
Typical High
$3,890.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$407.38
Typical High
$1,288.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$758.58
Typical High
$1,258.93
Medcost
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,000.00
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$891.25
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$6,309.57

Where North Carolina 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.

North Carolina· 45th of 51

$676

AK $1,905DE $562

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.