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CYP2D6 Drug Metabolism Gene Test

Georgia 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?

$513

Typical negotiated rate. In Georgia, October 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $525 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$204 to $661
FacilityA hospital or hospital-owned outpatient department$525$447 to $724

How much rates vary

Facilitymedian $525 · 10th to 90th $339 to $1,549Professionalmedian $501 · 10th to 90th $115 to $955
$100$200$500$1Kfacility $525professional $501

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
Facility
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$794.33
Aetna
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$331.13
Typical High
$436.52
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$512.86
Typical High
$1,548.82
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$562.34
Typical High
$891.25
CareSource
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$588.84
Typical High
$602.56
Cigna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$870.96
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$691.83
Typical High
$1,778.28
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$616.60
Typical High
$851.14
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$549.54
Typical High
$794.33
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$269.15
Typical High
$954.99
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
$151.36
Median
$177.83
Typical High
$218.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$60.26
Median
$70.79
Typical High
$87.10

Where Georgia 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.

Georgia· 14th of 51

$513

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.