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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 October 2026.

How much does CYP2C19 Drug Metabolism Gene Test cost?

$234

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $263 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$174$112 to $324
FacilityA hospital or hospital-owned outpatient department$263$234 to $389

How much rates vary

Facilitymedian $263 · 10th to 90th $135 to $550Professionalmedian $174 · 10th to 90th $112 to $1,047
$100$200$500$1Kfacility $263professional $174

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$234.42
Typical High
$245.47
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$234.42
Typical High
$288.40
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$288.40
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$112.20
Typical High
$288.40
CareSource
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$389.05
Typical High
$407.38
CareSource
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$380.19
Typical High
$478.63
Cigna
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$549.54
Typical High
$691.83
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$1,412.54
Typical High
$1,412.54
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$173.78
Typical High
$467.74
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
$102.33
Median
$117.49
Typical High
$144.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$40.74
Median
$46.77
Typical High
$58.88

Where Kentucky 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.

Kentucky· 40th of 51

$234

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.