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Fragile X Gene Test

Iowa 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?

$60.26

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $110 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 8 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$54.95$43.65 to $112
FacilityA hospital or hospital-owned outpatient department$110$57.54 to $158

How much rates vary

Facilitymedian $110 · 10th to 90th $44 to $182Professionalmedian $55 · 10th to 90th $34 to $380
$50$100$200$500facility $110professional $55

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
$43.65
Median
$134.90
Typical High
$181.97
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$50.12
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$134.90
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$134.90
Typical High
$380.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$69.18
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$58.88
Typical High
$229.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$75.86
Typical High
$75.86
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$61.66
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$144.54
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54

Where Iowa 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.

Iowa· 29th of 51

$60.26

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.