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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 October 2026.

How much does CYP2D6 Drug Metabolism Gene Test cost?

$513

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $513 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$513$407 to $871
FacilityA hospital or hospital-owned outpatient department$513$513 to $871

How much rates vary

Facilitymedian $513 · 10th to 90th $427 to $871Professionalmedian $513 · 10th to 90th $229 to $1,072
$200$500$1K$2Kfacility $513professional $513

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
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$512.86
Aetna
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$426.58
Cigna
Setting
Facility
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$870.96
Typical High
$1,071.52
Medica
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$512.86
Typical High
$524.81
Medica
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$407.38
Typical High
$831.76
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$1,047.13
Typical High
$1,230.27
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$269.15
Typical High
$446.68
Wellmark
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$446.68

Where South Dakota 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.

South Dakota· 13th of 51

$513

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.