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CYP2D6 Drug Metabolism Gene Test

South Dakota 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?

$832

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $832 for this service. The price depends on where it is billed: about $676 from a physician practice, and about $871 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 7 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$676$355 to $1,047
FacilityA hospital or hospital-owned outpatient department$871$832 to $871

How much rates vary

Facilitymedian $871 · 10th to 90th $513 to $871Professionalmedian $676 · 10th to 90th $302 to $1,175
$200.0$500.0$1.0K$2.0Kfacility $871professional $676

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
$512.86
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$354.81
Typical High
$426.58
Avera
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$870.96
Typical High
$1,071.52
Medica
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$512.86
Typical High
$1,258.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$2,238.72
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,047.13
Typical High
$1,230.27
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$446.68
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68

Where South Dakota 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 Dakota $832 · 2nd 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.