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Genetic Test For An Inherited Blood-Clotting Risk

New Jersey 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?

$58.88

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $58.88 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $155 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 6 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$51.29$50.12 to $56.23
FacilityA hospital or hospital-owned outpatient department$155$81.28 to $302

How much rates vary

Facilitymedian $155 · 10th to 90th $66 to $589Professionalmedian $51 · 10th to 90th $39 to $71
$50$200$1K$5K$20Kfacility $155professional $51

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
$70.79
Median
$154.88
Typical High
$407.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$51.29
Typical High
$66.07
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$218.78
Typical High
$6,025.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$144.54
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$52.48
Typical High
$100.00
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$69.18
Typical High
$125.89
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$66.07
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$39.81
Typical High
$70.79

Where New Jersey 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.

New Jersey· 44th of 51

$58.88

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.