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CYP2C19 Drug Metabolism Gene Test

Iowa rates for HCPCS 81225

A blood or cheek-swab test that examines common variations in the CYP2C19 gene, which controls one of the liver enzymes that break medicines down. The result predicts whether a person clears certain drugs quickly, normally, or slowly, so a prescriber can pick a suitable medicine or adjust the dose. Clopidogrel, several antidepressants, and some acid-reducing medicines depend on this enzyme.

Rates data updated October 2026.

How much does CYP2C19 Drug Metabolism Gene Test cost?

$316

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $427 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$288$174 to $562
FacilityA hospital or hospital-owned outpatient department$427$347 to $603

How much rates vary

Facilitymedian $427 · 10th to 90th $288 to $776Professionalmedian $288 · 10th to 90th $174 to $933
$200$500$1Kfacility $427professional $288

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$616.60
Typical High
$831.76
Aetna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$346.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$562.34
Typical High
$691.83
Hally Health
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$363.08
Typical High
$660.69
Medica
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$426.58
Typical High
$676.08
Medica
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$346.74
Typical High
$1,445.44
Midlands
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$389.05
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$316.23
Typical High
$616.60
United
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$741.31
United
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$602.56
Wellmark
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$114.82
Median
$114.82
Typical High
$173.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$45.71
Median
$45.71
Typical High
$69.18

Where Iowa sits

The same service costs 3.8 times more in Alaska than in Alabama. 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.

Iowa· 14th of 51

$316

AK $661AL $174

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.