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CYP2C19 Drug Metabolism Gene Test

Kentucky 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 July 2026.

How much does CYP2C19 Drug Metabolism Gene Test cost?

$229

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $229 for this service. The price depends on where it is billed: about $200 from a physician practice, and about $288 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$200$112 to $245
FacilityA hospital or hospital-owned outpatient department$288$240 to $437

How much rates vary

Facilitymedian $288 · 10th to 90th $229 to $692Professionalmedian $200 · 10th to 90th $112 to $380
$100.0$200.0$500.0$1.0Kfacility $288professional $200

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
$229.09
Median
$239.88
Typical High
$691.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$234.42
Typical High
$346.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$288.40
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$117.49
CareSource
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$549.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$380.19
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$549.54
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$1,412.54
Typical High
$1,412.54
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$288.40
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$295.12

Where Kentucky sits

The same service costs 3.8 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Kentucky $229 · 45th of 51
AK $661VT $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.