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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 July 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$417

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $417 for this service. The price depends on where it is billed: about $363 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 7 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$363$269 to $501
FacilityA hospital or hospital-owned outpatient department$537$407 to $617

How much rates vary

Facilitymedian $537 · 10th to 90th $347 to $832Professionalmedian $363 · 10th to 90th $191 to $776
$100.0$1.0K$10.0K$100.0Kfacility $537professional $363

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
$302.00
Median
$616.60
Typical High
$977.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$501.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$512.86
Typical High
$660.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$446.68
Typical High
$812.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
CareSource
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$588.84
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$724.44
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$457.09
Typical High
$1,174.90
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$588.84
Typical High
$1,000.00
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$549.54
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$407.38
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$575.44

Where Georgia 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.

Georgia $417 · 30th of 51
AK $1,023VT $269

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.