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Tumor Test For Fusion Gene Rearrangements

New Mexico 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?

$617

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $617 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $1,660 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$603$389 to $676
FacilityA hospital or hospital-owned outpatient department$1,660$776 to $3,467

How much rates vary

Facilitymedian $1,660 · 10th to 90th $468 to $4,365Professionalmedian $603 · 10th to 90th $219 to $3,388
$200$1K$5K$20Kfacility $1,660professional $603

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
$776.25
Median
$1,548.82
Typical High
$1,659.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$616.60
Typical High
$3,388.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$2,818.38
Typical High
$4,677.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$549.54
Typical High
$776.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$1,122.02
Providence
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$512.86
Typical High
$1,000.00
Providence
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$602.56
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$467.74
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$416.87

Where New Mexico 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.

New Mexico· 9th of 51

$617

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.