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Genetic Test Of One Gene

Pennsylvania 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?

$724

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $724 for this service. The price depends on where it is billed: about $692 from a physician practice, and about $1,479 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$692$550 to $794
FacilityA hospital or hospital-owned outpatient department$1,479$1,023 to $2,138

How much rates vary

Facilitymedian $1,479 · 10th to 90th $724 to $3,162Professionalmedian $692 · 10th to 90th $457 to $1,862
$500$1K$2K$5Kfacility $1,479professional $692

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
$724.44
Median
$1,621.81
Typical High
$3,019.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$691.83
Typical High
$3,019.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$3,090.30
Median
$4,168.69
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,380.38
Typical High
$2,884.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$724.44
Typical High
$1,479.11
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$1,096.48
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$1,023.29
Typical High
$1,584.89
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,621.81
Typical High
$2,884.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$691.83
Typical High
$3,019.95
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$933.25
Typical High
$2,089.30
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$851.14
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$1,258.93

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· 34th of 51

$724

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.