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CYP2C19 Drug Metabolism Gene Test

Massachusetts 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?

$295

Typical negotiated rate. In Massachusetts, October 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $417 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 9 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 $741
FacilityA hospital or hospital-owned outpatient department$417$288 to $692

How much rates vary

Facilitymedian $417 · 10th to 90th $214 to $912Professionalmedian $288 · 10th to 90th $174 to $1,445
$100$200$500$1K$2K$5Kfacility $417professional $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
$204.17
Median
$407.38
Typical High
$912.01
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$331.13
Typical High
$891.25
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$549.54
Typical High
$1,445.44
BCBS Massachusetts
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$645.65
Typical High
$933.25
BCBS Massachusetts
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$354.81
Typical High
$562.34
Cigna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$309.03
Typical High
$1,122.02
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$489.78
Typical High
$5,888.44
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$416.87
Typical High
$489.78
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$288.40
Typical High
$741.31
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$331.13
Typical High
$891.25
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$549.54
Typical High
$1,445.44
United
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$288.40
Typical High
$346.74
United
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$173.78
Typical High
$549.54
Well Sense
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$354.81
Typical High
$524.81
Well Sense
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$218.78
Typical High
$263.03
3 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
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
Fallon Health
Setting
Facility
Modifier
QW · Waived lab test
Typical Low
$288.40
Median
$380.19
Typical High
$446.68

Where Massachusetts 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.

Massachusetts· 19th of 51

$295

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.