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Tumor Test For Fusion Gene Rearrangements

California rates for HCPCS 81194

A laboratory test on a tumor sample that looks for rearrangements in a family of related genes that can become abnormally joined to other genes and drive cancer growth. The test covers the whole group of these genes together rather than one at a time. Finding a rearrangement identifies patients who may respond to a specific targeted cancer medicine.

Rates data updated July 2026.

How much does Tumor Test For Fusion Gene Rearrangements cost?

$550

Typical negotiated rate. In California, July 2026.

Insurers have agreed to pay about $550 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $1,202 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 10 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$437$309 to $759
FacilityA hospital or hospital-owned outpatient department$1,202$832 to $2,239

How much rates vary

Facilitymedian $1,202 · 10th to 90th $437 to $3,020Professionalmedian $437 · 10th to 90th $214 to $2,570
$100$200$500$1K$2K$5Kfacility $1,202professional $437

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
$645.65
Median
$1,174.90
Typical High
$3,090.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$436.52
Typical High
$3,388.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$1,318.26
Typical High
$2,570.40
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$1,023.29
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$2,238.72
Typical High
$5,128.61
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$912.01
Typical High
$1,905.46
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$1,479.11
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$512.86
Typical High
$691.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$575.44
Typical High
$912.01
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,454.71
Typical High
$2,454.71
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$3,890.45
Typical High
$3,890.45
Providence
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$616.60
Typical High
$1,348.96
Providence
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$512.86
Typical High
$1,096.48
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$512.86
Typical High
$6,165.95
United
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$512.86
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$1,148.15

Where California 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.

California· 12th of 51

$550

AK $1,175DE $347

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.