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Tumor Test For Fusion Gene Rearrangements

North Carolina 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?

$437

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $417 from a physician practice, and about $501 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$417$417 to $537
FacilityA hospital or hospital-owned outpatient department$501$447 to $813

How much rates vary

Facilitymedian $501 · 10th to 90th $417 to $1,738Professionalmedian $417 · 10th to 90th $339 to $832
$200$500$1K$2Kfacility $501professional $417

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
$416.87
Median
$457.09
Typical High
$1,737.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$416.87
Typical High
$691.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,122.02
Typical High
$1,174.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$512.86
Typical High
$933.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,122.02
Typical High
$2,344.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$257.04
Typical High
$794.33
Medcost
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$467.74
Typical High
$758.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$616.60
Typical High
$630.96
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$549.54
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$2,454.71
Typical High
$2,454.71
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$2,570.40
Typical High
$3,890.45

Where North Carolina 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.

North Carolina· 36th of 51

$437

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.