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CYP2D6 Drug Metabolism Gene Test

Idaho 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?

$457

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $457 for this service. The price depends on where it is billed: about $457 from a physician practice, and about $676 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$457$427 to $513
FacilityA hospital or hospital-owned outpatient department$676$447 to $1,072

How much rates vary

Facilitymedian $676 · 10th to 90th $347 to $1,585Professionalmedian $457 · 10th to 90th $316 to $871
$100.0$200.0$500.0$1.0Kfacility $676professional $457

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
$812.83
Median
$1,174.90
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$512.86
Typical High
$870.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$676.08
Typical High
$1,621.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$457.09
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$933.25
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$741.31
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$676.08
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$457.09
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$389.05
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$912.01
Typical High
$1,621.81
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$478.63
Select Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$588.84
Select Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$446.68

Where Idaho 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.

Idaho $457 · 16th 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.