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Single Gene Analysis

Illinois rates for HCPCS 81204

Reads one particular gene in a sample and reports which versions of it the person carries. Testing focuses on that single gene rather than scanning broadly, so it answers a specific question that has already been narrowed down by symptoms, family history, or earlier testing.

Rates data updated July 2026.

How much does Single Gene Analysis cost?

$135

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $209 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 5 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$117$112 to $166
FacilityA hospital or hospital-owned outpatient department$209$141 to $282

How much rates vary

Facilitymedian $209 · 10th to 90th $112 to $372Professionalmedian $117 · 10th to 90th $81 to $275
$100$200$500$1Kfacility $209professional $117

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
$112.20
Median
$208.93
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$117.49
Typical High
$234.42
BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$218.78
Typical High
$1,778.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$104.71
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$323.59
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$165.96
Typical High
$229.09
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$251.19
Typical High
$524.81
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$138.04

Where Illinois 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.

Illinois· 25th of 51

$135

AK $309DE $91.20

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.