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Tumor Test For Fusion Gene Rearrangements

South Dakota 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?

$832

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $832 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $1,000 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$617$407 to $1,202
FacilityA hospital or hospital-owned outpatient department$1,000$1,000 to $1,000

How much rates vary

Facilitymedian $1,000 · 10th to 90th $589 to $1,000Professionalmedian $617 · 10th to 90th $347 to $1,259
$200$500$1Kfacility $1,000professional $617

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
$363.08
Median
$588.84
Typical High
$588.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$489.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$1,000.00
Typical High
$1,230.27
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$588.84
Typical High
$954.99
Medica
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$2,570.40
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,202.26
Typical High
$1,412.54
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$309.03
Typical High
$691.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86

Where South Dakota 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.

South Dakota· 2nd of 51

$832

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.