go back

CYP2C19 Drug Metabolism Gene Test

West Virginia 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?

$240

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $363 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$234$214 to $245
FacilityA hospital or hospital-owned outpatient department$363$240 to $437

How much rates vary

Facilitymedian $363 · 10th to 90th $240 to $550Professionalmedian $234 · 10th to 90th $195 to $245
$100.0$200.0$500.0$1.0Kfacility $363professional $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
$239.88
Median
$363.08
Typical High
$436.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$234.42
Typical High
$245.47
CareSource
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
CareSource
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$346.74
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$549.54
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$1,412.54
Typical High
$1,412.54
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$323.59

Where West Virginia 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.

West Virginia $240 · 37th 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.