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CYP2C19 Drug Metabolism Gene Test

New Jersey 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 New Jersey, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $933 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 5 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$195$135 to $240
FacilityA hospital or hospital-owned outpatient department$933$372 to $1,738

How much rates vary

Facilitymedian $933 · 10th to 90th $269 to $2,951Professionalmedian $195 · 10th to 90th $135 to $339
$100.0$1.0K$10.0K$100.0Kfacility $933professional $195

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
$371.54
Median
$1,122.02
Typical High
$2,344.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$645.65
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$234.42
Typical High
$436.52
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$309.03
Typical High
$467.74
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$9,549.93
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$288.40
Typical High
$630.96
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$309.03

Where New Jersey 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.

New Jersey $234 · 42nd 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.