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CYP2C19 Drug Metabolism Gene Test

Rhode Island 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?

$204

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $437 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 4 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$204$145 to $219
FacilityA hospital or hospital-owned outpatient department$437$347 to $646

How much rates vary

Facilitymedian $437 · 10th to 90th $288 to $1,660Professionalmedian $204 · 10th to 90th $135 to $288
$200$500$1Kfacility $437professional $204

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$645.65
Typical High
$1,659.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$338.84
Typical High
$436.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$812.83
Typical High
$891.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$426.58

Where Rhode Island sits

The same service costs 3.8 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 49th of 51

$204

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.