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CYP2D6 Drug Metabolism Gene Test

Rhode Island 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?

$288

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $257 from a physician practice, and about $525 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$257$204 to $339
FacilityA hospital or hospital-owned outpatient department$525$447 to $575

How much rates vary

Facilitymedian $525 · 10th to 90th $407 to $1,230Professionalmedian $257 · 10th to 90th $191 to $617
$200$500$1Kfacility $525professional $257

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$524.81
Typical High
$575.44
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$288.40
Typical High
$338.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$794.33
Median
$1,230.27
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$616.60
Typical High
$616.60
United
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$269.15
Typical High
$758.58

Where Rhode Island 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.

Rhode Island· 50th of 51

$288

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.