go back

CYP2D6 Drug Metabolism Gene Test

Virginia 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?

$407

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $407 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $537 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$339$209 to $407
FacilityA hospital or hospital-owned outpatient department$537$447 to $1,047

How much rates vary

Facilitymedian $537 · 10th to 90th $380 to $1,995Professionalmedian $339 · 10th to 90th $182 to $871
$10.0$100.0$1.0K$10.0Kfacility $537professional $339

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
$338.84
Median
$1,000.00
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$380.19
Typical High
$1,122.02
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$1,819.70
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$302.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$954.99
Typical High
$1,445.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$1,122.02
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$275.42
Typical High
$758.58
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$501.19
Typical High
$630.96
Medcost
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$776.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$602.56
Typical High
$954.99
Sentara
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$588.84
Typical High
$10,000.00
Sentara
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$588.84
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$446.68
Typical High
$537.03
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$229.09
Typical High
$524.81

Where Virginia 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.

Virginia $407 · 31st 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.