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CYP2D6 Drug Metabolism Gene Test

Montana 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?

$661

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $776 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$603$407 to $661
FacilityA hospital or hospital-owned outpatient department$776$676 to $832

How much rates vary

Facilitymedian $776 · 10th to 90th $603 to $1,047Professionalmedian $603 · 10th to 90th $191 to $813
$200$500$1K$2Kfacility $776professional $603

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
$512.86
Median
$512.86
Typical High
$512.86
BCBS Montana
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$2,754.23
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Cigna
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$676.08
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$524.81
Median
$776.25
Typical High
$912.01
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$776.25
Typical High
$831.76
Providence
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$676.08
Typical High
$2,570.40
Providence
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$660.69
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$446.68

Where Montana 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.

Montana· 3rd of 51

$661

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.