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CYP2C19 Drug Metabolism Gene Test

Maryland 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?

$219

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $219 for this service. Most negotiated rates run $182 to $234.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $219 · 10th to 90th $132 to $288
$200$500professional $219

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
Professional
Modifier
None
Typical Low
$213.80
Median
$218.78
Typical High
$223.87
CareFirst
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$234.42
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$263.03
Typical High
$851.14
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$346.74
Typical High
$436.52
United
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$144.54
Typical High
$257.04
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
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
$107.15
Median
$109.65
Typical High
$109.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$42.66
Median
$43.65
Typical High
$44.67

Where Maryland 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.

Maryland· 44th of 51

$219

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.