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Genetic Test For An Inherited Blood-Clotting Risk

South Dakota 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?

$97.72

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $97.72 for this service. The price depends on where it is billed: about $61.66 from a physician practice, and about $204 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$61.66$51.29 to $158
FacilityA hospital or hospital-owned outpatient department$204$126 to $209

How much rates vary

Facilitymedian $204 · 10th to 90th $74 to $209Professionalmedian $62 · 10th to 90th $50 to $214
$50$100$200facility $204professional $62

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
$194.98
Median
$204.17
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$213.80
Avera
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$66.07
Typical High
$97.72
Avera
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$69.18
Typical High
$69.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$125.89
Typical High
$158.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$186.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$331.13
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$154.88
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$39.81
Typical High
$87.10
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07

Where South Dakota 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.

South Dakota· 9th of 51

$97.72

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.