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Tumor Test For Fusion Gene Rearrangements

Utah 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?

$468

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $468 for this service. The price depends on where it is billed: about $468 from a physician practice, and about $2,455 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 7 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$468$437 to $468
FacilityA hospital or hospital-owned outpatient department$2,455$603 to $2,512

How much rates vary

Facilitymedian $2,455 · 10th to 90th $468 to $3,311Professionalmedian $468 · 10th to 90th $224 to $617
$200$500$1K$2Kfacility $2,455professional $468

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
$467.74
Median
$2,511.89
Typical High
$3,311.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$537.03
Typical High
$954.99
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$2,089.30
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$512.86
Select Health
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$457.09
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$512.86

Where Utah 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.

Utah· 33rd of 51

$468

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.