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Tumor Test For Fusion Gene Rearrangements

Ohio 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 Ohio, 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 $724 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 8 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$269 to $501
FacilityA hospital or hospital-owned outpatient department$724$513 to $1,148

How much rates vary

Facilitymedian $724 · 10th to 90th $427 to $2,089Professionalmedian $417 · 10th to 90th $209 to $891
$200$500$1K$2Kfacility $724professional $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
$426.58
Median
$891.25
Typical High
$2,089.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$1,230.27
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$549.54
Typical High
$954.99
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$263.03
Typical High
$676.08
CareSource
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$602.56
Typical High
$724.44
CareSource
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$676.08
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$288.40
Typical High
$1,023.29
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$676.08
Typical High
$2,884.03
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$288.40
Typical High
$1,000.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$426.58
Typical High
$549.54
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$616.60
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$724.44

Where Ohio 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.

Ohio· 39th 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.