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Tumor Test For Fusion Gene Rearrangements

Rhode Island 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?

$380

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $380 for this service. The price depends on where it is billed: about $380 from a physician practice, and about $661 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 4 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$380$363 to $389
FacilityA hospital or hospital-owned outpatient department$661$603 to $2,344

How much rates vary

Facilitymedian $661 · 10th to 90th $513 to $2,344Professionalmedian $380 · 10th to 90th $309 to $513
$200$500$1K$2Kfacility $661professional $380

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$2,344.23
Typical High
$2,344.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$380.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$602.56
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$724.44
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$741.31

Where Rhode Island 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.

Rhode Island· 49th of 51

$380

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.