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CYP2D6 Drug Metabolism Gene Test

Connecticut rates for HCPCS 81226

Examines the CYP2D6 gene, which carries the instructions for a liver enzyme that breaks down a large share of common medicines. The test checks for the usual variants, including extra or missing copies of the gene, and reports whether a person clears those drugs slowly, normally, or unusually fast.

Rates data updated October 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$302

Typical negotiated rate. In Connecticut, October 2026.

Insurers have agreed to pay about $302 for this service. Most negotiated rates run $229 to $575.

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.

How much rates vary

Facilitymedian $537 · 10th to 90th $195 to $1,122Professionalmedian $269 · 10th to 90th $204 to $661
$200$500$1Kfacility $537professional $269

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$302.00
Typical High
$316.23
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$524.81
Typical High
$1,122.02
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$229.09
Typical High
$575.44
Cigna
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$724.44
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$562.34
Typical High
$1,000.00
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$602.56
Typical High
$724.44
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$269.15
Typical High
$575.44
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$123.03
Median
$147.91
Typical High
$158.49
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$48.98
Median
$60.26
Typical High
$63.10

Where Connecticut sits

The same service costs 3.7 times more in Alaska than in Florida. 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.

Connecticut· 47th of 51

$302

AK $1,023FL $275

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.