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Tumor Test For Fusion Gene Rearrangements

Virginia 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 Virginia, July 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $550 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$389$234 to $437
FacilityA hospital or hospital-owned outpatient department$550$513 to $1,096

How much rates vary

Facilitymedian $550 · 10th to 90th $437 to $1,905Professionalmedian $389 · 10th to 90th $209 to $955
$200$500$1K$2K$5K$10Kfacility $550professional $389

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
$389.05
Median
$977.24
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$436.52
Typical High
$977.24
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$2,089.30
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$346.74
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$1,548.82
Typical High
$2,344.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,000.00
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$323.59
Typical High
$831.76
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$575.44
Typical High
$724.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$512.86
Typical High
$891.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$1,096.48
Sentara
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$602.56
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$616.60
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$512.86
Typical High
$616.60
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$263.03
Typical High
$602.56

Where Virginia 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.

Virginia· 38th 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.