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Fragile X Gene Test

Illinois 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?

$48.98

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $46.77 from a physician practice, and about $93.33 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$46.77$39.81 to $69.18
FacilityA hospital or hospital-owned outpatient department$93.33$60.26 to $117

How much rates vary

Facilitymedian $93 · 10th to 90th $49 to $200Professionalmedian $47 · 10th to 90th $3 to $98
$5.0$20.0$100.0$500.0facility $93professional $47

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
$48.98
Median
$91.20
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$51.29
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$199.53
Typical High
$707.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$39.81
Typical High
$43.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$128.82
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$69.18
Typical High
$95.50
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$144.54
Typical High
$478.63
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$60.26

Where Illinois sits

The same service costs 3.0 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $48.98 · 46th of 51
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.