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CYP2D6 Drug Metabolism Gene Test

Iowa 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?

$447

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $708 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 8 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$389$347 to $871
FacilityA hospital or hospital-owned outpatient department$708$447 to $1,202

How much rates vary

Facilitymedian $708 · 10th to 90th $347 to $1,318Professionalmedian $389 · 10th to 90th $269 to $2,951
$10.0$50.0$200.0$1.0Kfacility $708professional $389

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
$346.74
Median
$1,071.52
Typical High
$1,318.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$389.05
Typical High
$2,951.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$870.96
Typical High
$1,071.52
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$741.31
Typical High
$891.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$1,148.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$537.03
Typical High
$1,737.80
Midlands
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$602.56
Typical High
$602.56
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$489.78
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$1,148.15
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68

Where Iowa 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.

Iowa $447 · 22nd 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.