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CYP2D6 Drug Metabolism Gene Test

New York 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 New York, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $363 from a physician practice, and about $741 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 9 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$363$204 to $525
FacilityA hospital or hospital-owned outpatient department$741$447 to $1,047

How much rates vary

Facilitymedian $741 · 10th to 90th $372 to $1,230Professionalmedian $363 · 10th to 90th $182 to $813
$100.0$1.0K$10.0K$100.0Kfacility $741professional $363

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
$363.08
Median
$776.25
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$363.08
Typical High
$812.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,174.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$831.76
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$446.68
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$446.68
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$954.99
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$588.84
Typical High
$2,187.76
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$741.31
Typical High
$1,737.80
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$380.19
Typical High
$851.14
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$426.58
Typical High
$812.83
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$588.84
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$446.68
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$446.68
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$331.13
Typical High
$691.83
Univera
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$380.19
Typical High
$478.63
Univera
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$426.58
Typical High
$1,071.52

Where New York 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 York $447 · 20th 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.