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CYP2D6 Drug Metabolism Gene Test

West 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?

$372

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $372 for this service. The price depends on where it is billed: about $363 from a physician practice, and about $562 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 4 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$363$331 to $380
FacilityA hospital or hospital-owned outpatient department$562$372 to $676

How much rates vary

Facilitymedian $562 · 10th to 90th $372 to $794Professionalmedian $363 · 10th to 90th $302 to $380
$200.0$500.0$1.0K$2.0Kfacility $562professional $363

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
$371.54
Median
$562.34
Typical High
$676.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$380.19
CareSource
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
CareSource
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$537.03
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$794.33
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$2,187.76
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$223.87
Typical High
$501.19

Where West 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.

West Virginia $372 · 39th 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.