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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 July 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$380

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $380 for this service. The price depends on where it is billed: about $363 from a physician practice, and about $631 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 8 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$219 to $427
FacilityA hospital or hospital-owned outpatient department$631$447 to $1,000

How much rates vary

Facilitymedian $631 · 10th to 90th $372 to $1,820Professionalmedian $363 · 10th to 90th $182 to $741
$100.0$200.0$500.0$1.0K$2.0Kfacility $631professional $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
$812.83
Typical High
$1,819.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$1,071.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$478.63
Typical High
$831.76
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$223.87
Typical High
$588.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$512.86
Typical High
$630.96
CareSource
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$588.84
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$398.11
Typical High
$1,000.00
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$602.56
Typical High
$1,862.09
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$257.04
Typical High
$891.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$407.38
Typical High
$489.78
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$501.19
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$630.96

Where Ohio 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.

Ohio $380 · 38th 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.