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CYP2C19 Drug Metabolism Gene Test

Maine 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 Maine, 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 $468 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 6 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$234 to $288
FacilityA hospital or hospital-owned outpatient department$468$288 to $1,047

How much rates vary

Facilitymedian $468 · 10th to 90th $288 to $1,148Professionalmedian $288 · 10th to 90th $174 to $324
$100.0$200.0$500.0$1.0K$2.0Kfacility $468professional $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
$288.40
Median
$288.40
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$234.42
Typical High
$288.40
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$1,047.13
Typical High
$1,148.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$173.78
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$288.40
Typical High
$295.12
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$346.74
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$1,288.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$288.40
Typical High
$446.68

Where Maine 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.

Maine $288 · 22nd 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.