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CYP2D6 Drug Metabolism Gene Test

New Jersey 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?

$363

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $1,445 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$302$204 to $372
FacilityA hospital or hospital-owned outpatient department$1,445$575 to $2,818

How much rates vary

Facilitymedian $1,445 · 10th to 90th $437 to $7,762Professionalmedian $302 · 10th to 90th $204 to $513
$100.0$1.0K$10.0K$100.0Kfacility $1,445professional $302

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
$575.44
Median
$1,445.44
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$331.13
Typical High
$512.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,000.00
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$363.08
Typical High
$676.08
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$851.14
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$446.68
Typical High
$977.24
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$269.15
Typical High
$457.09

Where New Jersey 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.

New Jersey $363 · 42nd 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.