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Tumor Test For Fusion Gene Rearrangements

Michigan 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?

$490

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $427 from a physician practice, and about $490 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 7 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$389 to $490
FacilityA hospital or hospital-owned outpatient department$490$490 to $617

How much rates vary

Facilitymedian $490 · 10th to 90th $490 to $912Professionalmedian $427 · 10th to 90th $282 to $617
$200$500$1Kfacility $490professional $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
$489.78
Median
$489.78
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$489.78
Typical High
$616.60
BCBS
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$389.05
Typical High
$389.05
BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$389.05
Typical High
$389.05
CareSource
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
CareSource
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$575.44
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$288.40
Typical High
$724.44
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$537.03
Typical High
$1,230.27
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$512.86
Typical High
$707.95
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$616.60
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$512.86

Where Michigan 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.

Michigan· 31st of 51

$490

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.