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Tumor Test For Fusion Gene Rearrangements

Kentucky 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?

$407

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $407 for this service. The price depends on where it is billed: about $355 from a physician practice, and about $513 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$355$209 to $437
FacilityA hospital or hospital-owned outpatient department$513$427 to $759

How much rates vary

Facilitymedian $513 · 10th to 90th $427 to $1,230Professionalmedian $355 · 10th to 90th $209 to $676
$200$500$1K$2Kfacility $513professional $355

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
$426.58
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$416.87
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$512.86
Typical High
$549.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
CareSource
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$724.44
Typical High
$977.24
CareSource
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$676.08
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$758.58
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$831.76
Typical High
$2,511.89
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$512.86

Where Kentucky 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.

Kentucky· 46th of 51

$407

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.