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CYP2D6 Drug Metabolism Gene Test

Wisconsin 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?

$537

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $537 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $1,202 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 12 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$513$204 to $1,023
FacilityA hospital or hospital-owned outpatient department$1,202$537 to $1,349

How much rates vary

Facilitymedian $1,202 · 10th to 90th $490 to $2,138Professionalmedian $513 · 10th to 90th $182 to $1,549
$10.0$50.0$200.0$1.0Kfacility $1,202professional $513

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
$537.03
Median
$1,230.27
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$426.58
Typical High
$676.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,202.26
Typical High
$1,230.27
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$1,862.09
CareSource
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$602.56
CareSource
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$501.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,318.26
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$1,071.52
Typical High
$1,412.54
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,905.46
Typical High
$2,884.03
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$3,019.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$575.44
Typical High
$1,584.89
Medica
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$269.15
Typical High
$1,380.38
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$537.03
Typical High
$691.83
Network Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$724.44
Typical High
$1,288.25
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$575.44
Typical High
$1,348.96
Quartz
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$1,071.52
Typical High
$1,479.11
Quartz
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,137.96
Typical High
$2,137.96
Quartz
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$2,238.72
Typical High
$2,238.72
Security Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$954.99
Security Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$2,454.71
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$363.08
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$741.31

Where Wisconsin 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.

Wisconsin $537 · 10th 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.