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CYP2C19 Drug Metabolism Gene Test

North Carolina 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?

$234

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $339 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$234$191 to $288
FacilityA hospital or hospital-owned outpatient department$339$234 to $661

How much rates vary

Facilitymedian $339 · 10th to 90th $105 to $759Professionalmedian $234 · 10th to 90th $145 to $389
$10.0$50.0$200.0$1.0Kfacility $339professional $234

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
$104.71
Median
$323.59
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$234.42
Typical High
$389.05
BCBS
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$660.69
Typical High
$912.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$630.96
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$138.04
Typical High
$389.05
Medcost
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$275.42
Typical High
$457.09
Medcost
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$346.74
Typical High
$389.05
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$309.03
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,380.38
Median
$1,380.38
Typical High
$1,380.38
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$2,187.76

Where North Carolina 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.

North Carolina $234 · 40th 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.