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CYP2D6 Drug Metabolism Gene Test

Indiana 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?

$380

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $380 for this service. The price depends on where it is billed: about $372 from a physician practice, and about $447 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 5 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$372$229 to $372
FacilityA hospital or hospital-owned outpatient department$447$447 to $912

How much rates vary

Facilitymedian $447 · 10th to 90th $447 to $1,349Professionalmedian $372 · 10th to 90th $145 to $417
$10.0$100.0$1.0Kfacility $447professional $372

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
$371.54
Median
$478.63
Typical High
$1,348.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$371.54
Typical High
$407.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,348.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$288.40
CareSource
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$446.68
Typical High
$630.96
CareSource
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$512.86
Typical High
$630.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$446.68
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$416.87
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$537.03

Where Indiana 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.

Indiana $380 · 35th 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.