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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 October 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$316

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $6,457 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$295$219 to $316
FacilityA hospital or hospital-owned outpatient department$6,457$1,072 to $16,982

How much rates vary

Facilitymedian $6,457 · 10th to 90th $501 to $23,988Professionalmedian $295 · 10th to 90th $204 to $447
$200$500$1K$2K$5K$10K$20Kfacility $6,457professional $295

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
Facility
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$295.12
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$363.08
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$102.33
Median
$102.33
Typical High
$181.97
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$40.74
Median
$40.74
Typical High
$72.44
Cigna
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$1,258.93
Typical High
$2,187.76
Cigna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$478.63
Typical High
$933.25
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$588.84
Typical High
$660.69
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$14,791.08
Typical High
$26,915.35
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
United
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$269.15
Typical High
$446.68

Where New Jersey 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.

New Jersey· 46th of 51

$316

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.