go back

CYP2D6 Drug Metabolism Gene Test

Massachusetts 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 Massachusetts, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $447 from a physician practice, and about $891 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$447$347 to $447
FacilityA hospital or hospital-owned outpatient department$891$617 to $1,259

How much rates vary

Facilitymedian $891 · 10th to 90th $331 to $1,445Professionalmedian $447 · 10th to 90th $245 to $1,122
$100.0$1.0K$10.0Kfacility $891professional $447

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
$316.23
Median
$870.96
Typical High
$1,445.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$316.23
Typical High
$1,348.96
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$512.86
Typical High
$1,479.11
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$1,513.56
BCBS
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$891.25
Typical High
$1,288.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$549.54
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$478.63
Typical High
$1,174.90
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$645.65
Typical High
$758.58
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$812.83
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$512.86
Typical High
$1,479.11
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$537.03
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$1,000.00

Where Massachusetts 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.

Massachusetts $447 · 24th 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.