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CYP2D6 Drug Metabolism Gene Test

Maryland 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 October 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$331

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $331 for this service. Most negotiated rates run $288 to $363.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $331 · 10th to 90th $204 to $447
$200$500$1Kprofessional $331

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$338.84
Typical High
$338.84
CareFirst
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$363.08
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$331.13
Typical High
$1,288.25
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$537.03
Typical High
$676.08
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$398.11
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$165.96
Median
$169.82
Typical High
$169.82
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$66.07
Median
$67.61
Typical High
$69.18

Where Maryland sits

The same service costs 3.7 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maryland· 44th of 51

$331

AK $1,023FL $275

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.