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Tumor Test For Fusion Gene Rearrangements

Maine 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?

$513

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $692 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$513$417 to $513
FacilityA hospital or hospital-owned outpatient department$692$513 to $2,291

How much rates vary

Facilitymedian $692 · 10th to 90th $513 to $3,311Professionalmedian $513 · 10th to 90th $309 to $617
$200$500$1K$2Kfacility $692professional $513

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
$512.86
Median
$512.86
Typical High
$2,290.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$512.86
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$3,311.31
Typical High
$3,630.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$309.03
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$524.81
Typical High
$660.69
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$616.60
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$2,290.87
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$512.86
Typical High
$575.44
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$794.33

Where Maine 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.

Maine· 22nd of 51

$513

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.