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Carrier Test For A Specific Inherited Change

Vermont rates for HCPCS 81209

A blood or saliva test that looks for one or more specific known inherited changes in a single gene, examining those defined changes rather than reading the whole gene from end to end. It is used in carrier screening, where a healthy person is checked for a change that would matter if their partner carried one in the same gene. The result covers only the one gene examined.

Rates data updated July 2026.

How much does Carrier Test For A Specific Inherited Change cost?

$38.90

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $38.90 for this service. The price depends on where it is billed: about $38.90 from a physician practice, and about $66.07 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$38.90$35.48 to $66.07
FacilityA hospital or hospital-owned outpatient department$66.07$38.90 to $81.28

How much rates vary

Facilitymedian $66 · 10th to 90th $39 to $102Professionalmedian $39 · 10th to 90th $32 to $66
$50$100facility $66professional $39

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
Professional
Modifier
Global
Typical Low
$32.36
Median
$38.90
Typical High
$66.07
BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$45.71
Typical High
$89.13
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$45.71
Typical High
$87.10

Where Vermont sits

The same service costs 3.0 times more in Alaska than in Washington, DC. 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.

Vermont· 29th of 51

$38.90

AK $89.13DC $29.51

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.