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CYP2D6 Drug Metabolism Gene Test

Ohio 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?

$363

Typical negotiated rate. In Ohio, October 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $603 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$234$182 to $398
FacilityA hospital or hospital-owned outpatient department$603$479 to $832

How much rates vary

Facilitymedian $603 · 10th to 90th $417 to $1,288Professionalmedian $234 · 10th to 90th $182 to $724
$200$500$1K$2Kfacility $603professional $234

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
$426.58
Median
$933.25
Typical High
$1,819.70
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$213.80
Median
$467.74
Typical High
$912.01
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$85.11
Median
$190.55
Typical High
$363.08
Aetna
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$181.97
Median
$181.97
Typical High
$645.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$72.44
Median
$72.44
Typical High
$263.03
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$524.81
Typical High
$831.76
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$181.97
Typical High
$588.84
CareSource
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$602.56
Cigna
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$588.84
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$812.83
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$478.63
Median
$602.56
Typical High
$1,862.09
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$812.83
Molina
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$407.38
Typical High
$562.34
SummaCare
Setting
Professional
Modifier
None
Typical Low
$380.19
Median
$549.54
Typical High
$707.95
United
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$407.38
Typical High
$676.08
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$269.15
Typical High
$645.65

Where Ohio 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.

Ohio· 39th of 51

$363

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.