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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 July 2026.

How much does CYP2C19 Drug Metabolism Gene Test cost?

$288

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $575 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 8 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$288$224 to $295
FacilityA hospital or hospital-owned outpatient department$575$398 to $832

How much rates vary

Facilitymedian $575 · 10th to 90th $214 to $977Professionalmedian $288 · 10th to 90th $158 to $724
$100.0$1.0K$10.0Kfacility $575professional $288

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
$204.17
Median
$575.44
Typical High
$977.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$870.96
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$331.13
Typical High
$954.99
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$295.12
Typical High
$977.24
BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$575.44
Typical High
$831.76
BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$354.81
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$309.03
Typical High
$758.58
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$416.87
Typical High
$489.78
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$524.81
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$331.13
Typical High
$954.99
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$295.12
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$288.40
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$288.40
Typical High
$645.65

Where Massachusetts 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.

Massachusetts $288 · 17th 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.