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Gene Test For Myotonic Dystrophy

Pennsylvania rates for HCPCS 81234

A blood test that checks a gene for an abnormally long stretch of repeated DNA letters, the change that causes myotonic dystrophy. That inherited condition brings gradual muscle weakness and difficulty relaxing muscles after gripping or clenching, and can also affect the heart, eyes and other organs.

Rates data updated October 2026.

How much does Gene Test For Myotonic Dystrophy cost?

$112

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $214 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$112$100 to $138
FacilityA hospital or hospital-owned outpatient department$214$138 to $468

How much rates vary

Facilitymedian $214 · 10th to 90th $112 to $692Professionalmedian $112 · 10th to 90th $69 to $204
$100$200$500$1K$2K$5Kfacility $214professional $112

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$117.49
Typical High
$398.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$112.20
Typical High
$117.49
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$53.70
Median
$54.95
Typical High
$58.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$21.88
Median
$22.39
Typical High
$23.44
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$691.83
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$107.15
Typical High
$331.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$223.87
Typical High
$416.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$128.82
Typical High
$208.93
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$177.83
Typical High
$177.83
Geisinger
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Geisinger
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$158.49
Typical High
$269.15
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$933.25
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$467.74
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$112.20
Typical High
$117.49
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$53.70
Median
$54.95
Typical High
$58.88
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$21.88
Median
$22.39
Typical High
$23.44
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$338.84
Typical High
$630.96
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$151.36
Typical High
$151.36
United
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$138.04
Typical High
$165.96
United
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$81.28
Typical High
$165.96

Where Pennsylvania sits

The same service costs 5.5 times more in Texas than in Alabama. 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.

Pennsylvania· 38th of 51

$112

TX $347AL $63.10

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.