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CYP2C19 Drug Metabolism Gene Test

Pennsylvania 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?

$245

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $513 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 9 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 $275
FacilityA hospital or hospital-owned outpatient department$513$339 to $741

How much rates vary

Facilitymedian $513 · 10th to 90th $245 to $1,000Professionalmedian $234 · 10th to 90th $158 to $692
$200.0$1.0K$5.0K$20.0Kfacility $513professional $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
$245.47
Median
$562.34
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$234.42
Typical High
$1,047.13
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$478.63
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$281.84
Typical High
$660.69
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$380.19
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$446.68
Typical High
$741.31
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$512.86
Typical High
$912.01
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$562.34
Typical High
$1,000.00
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$234.42
Typical High
$1,047.13
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$354.81
Typical High
$524.81
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$323.59
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$288.40
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$407.38

Where Pennsylvania 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.

Pennsylvania $245 · 35th 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.