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Genetic Test For An Inherited Blood-Clotting Risk

North Carolina rates for HCPCS 81240

A blood sample is tested for a specific, common genetic change in a clotting-related gene that is linked to an increased risk of developing blood clots. This test is often ordered as part of a workup for someone who has had an unexplained blood clot or has a family history of clotting problems.

Rates data updated July 2026.

How much does Genetic Test For An Inherited Blood-Clotting Risk cost?

$87.10

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $182 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 7 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$53.70$50.12 to $87.10
FacilityA hospital or hospital-owned outpatient department$182$87.10 to $219

How much rates vary

Facilitymedian $182 · 10th to 90th $52 to $447Professionalmedian $54 · 10th to 90th $36 to $105
$50$100$200$500facility $182professional $54

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
$52.48
Median
$190.55
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$52.48
Typical High
$112.20
BCBS
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$66.07
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$144.54
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.90
Typical High
$89.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$63.10
Typical High
$102.33
Medcost
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$77.62
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$39.81
Typical High
$100.00
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$489.78

Where North Carolina sits

The same service costs 4.5 times more in West Virginia than in Rhode Island. 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.

North Carolina· 14th of 51

$87.10

WV $224RI $50.12

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.