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Fragile X Gene Test

Washington, DC rates for HCPCS 81243

A laboratory test on a blood sample that examines a specific gene on the X chromosome for an abnormally expanded stretch of repeated genetic letters. That expansion is the cause of fragile X syndrome, an inherited condition that can cause developmental delay and intellectual disability. The test identifies whether such an expansion is present.

Rates data updated July 2026.

How much does Fragile X Gene Test cost?

$42.66

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $42.66 for this service. The price depends on where it is billed: about $42.66 from a physician practice, and about $331 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 5 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$42.66$42.66 to $44.67
FacilityA hospital or hospital-owned outpatient department$331$42.66 to $347

How much rates vary

Facilitymedian $331 · 10th to 90th $43 to $347Professionalmedian $43 · 10th to 90th $43 to $115
$50$100$200$500$1Kfacility $331professional $43

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
$42.66
Median
$331.13
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$44.67
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$446.68
Typical High
$1,548.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$95.50
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$72.44
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$100.00
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$69.18
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$25.70
Typical High
$70.79

Where Washington, DC sits

The same service costs 3.0 times more in Alaska than in Washington, DC. 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.

Washington, DC· 51st of 51

$42.66

AK $129DC $42.66

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.