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CYP2D6 Drug Metabolism Gene Test

South Carolina 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?

$363

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $355 from a physician practice, and about $832 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 5 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$355$355 to $372
FacilityA hospital or hospital-owned outpatient department$832$355 to $1,445

How much rates vary

Facilitymedian $832 · 10th to 90th $316 to $2,138Professionalmedian $355 · 10th to 90th $224 to $479
$10.0$50.0$200.0$1.0Kfacility $832professional $355

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
$316.23
Median
$1,122.02
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$407.38
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,754.23
Median
$2,754.23
Typical High
$2,951.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$380.19
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,348.96
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$208.93
Typical High
$478.63
Medcost
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$426.58
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$446.68
Typical High
$537.03
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$446.68

Where South Carolina 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.

South Carolina $363 · 41st 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.