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Tumor Test For Fusion Gene Rearrangements

Illinois 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?

$427

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $427 for this service. The price depends on where it is billed: about $427 from a physician practice, and about $794 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 5 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$427$324 to $490
FacilityA hospital or hospital-owned outpatient department$794$537 to $1,047

How much rates vary

Facilitymedian $794 · 10th to 90th $427 to $1,349Professionalmedian $427 · 10th to 90th $3 to $871
$10$100$1Kfacility $794professional $427

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
$426.58
Median
$794.33
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$436.52
Typical High
$891.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$831.76
Typical High
$6,760.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$354.81
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$1,202.26
Typical High
$2,398.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$630.96
Typical High
$870.96
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$851.14
Typical High
$1,412.54
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,047.13
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$549.54

Where Illinois 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.

Illinois· 42nd of 51

$427

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.