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CYP2C19 Drug Metabolism Gene Test

South 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 South Carolina, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $229 from a physician practice, and about $537 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$229$229 to $251
FacilityA hospital or hospital-owned outpatient department$537$229 to $933

How much rates vary

Facilitymedian $537 · 10th to 90th $204 to $1,380Professionalmedian $229 · 10th to 90th $174 to $309
$200$500$1Kfacility $537professional $229

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
$204.17
Median
$724.44
Typical High
$1,380.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,905.46
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$302.00
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$870.96
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$134.90
Typical High
$309.03
Medcost
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$275.42
Typical High
$524.81
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
$295.12

Where South Carolina 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.

South Carolina· 39th of 51

$234

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.