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CYP2D6 Drug Metabolism Gene Test

Vermont 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?

$269

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $513 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$269$204 to $316
FacilityA hospital or hospital-owned outpatient department$513$447 to $661

How much rates vary

Facilitymedian $513 · 10th to 90th $447 to $759Professionalmedian $269 · 10th to 90th $204 to $447
$200.0$500.0$1.0K$2.0Kfacility $513professional $269

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. 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
Global
Typical Low
$204.17
Median
$204.17
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$660.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$549.54
Typical High
$1,023.29
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$524.81
Typical High
$1,000.00

Where Vermont 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.

Vermont $269 · 51st 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.