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CYP2D6 Drug Metabolism Gene Test

Maine 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 Maine, 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 $724 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 6 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$363 to $447
FacilityA hospital or hospital-owned outpatient department$724$447 to $1,122

How much rates vary

Facilitymedian $724 · 10th to 90th $447 to $1,288Professionalmedian $447 · 10th to 90th $269 to $501
$200.0$500.0$1.0K$2.0Kfacility $724professional $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
$446.68
Median
$446.68
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$363.08
Typical High
$446.68
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,096.48
Typical High
$1,174.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$446.68
Typical High
$457.09
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$537.03
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,995.26
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$446.68
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$691.83

Where Maine 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.

Maine $447 · 23rd 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.