go back

CYP2C19 Drug Metabolism Gene Test

Montana 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?

$389

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $363 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$363$339 to $676
FacilityA hospital or hospital-owned outpatient department$468$363 to $851

How much rates vary

Facilitymedian $468 · 10th to 90th $295 to $1,778Professionalmedian $363 · 10th to 90th $123 to $1,905
$200.0$1.0K$5.0K$20.0K$100.0Kfacility $468professional $363

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
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$1,905.46
BCBS
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$1,778.28
Typical High
$87,096.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$489.78
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$436.52
Typical High
$891.25
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$436.52
Typical High
$891.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$562.34
Typical High
$1,659.59
Providence
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$295.12

Where Montana 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.

Montana $389 · 5th 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.