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Fragile X Gene Test

Kentucky 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?

$70.79

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $70.79 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $60.26 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$70.79$45.71 to $70.79
FacilityA hospital or hospital-owned outpatient department$60.26$46.77 to $79.43

How much rates vary

Facilitymedian $60 · 10th to 90th $47 to $138Professionalmedian $71 · 10th to 90th $40 to $83
$50$100$200facility $60professional $71

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
$46.77
Median
$57.54
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$46.77
Typical High
$83.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$57.54
Typical High
$60.26
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$70.79
Typical High
$70.79
CareSource
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$79.43
Typical High
$107.15
CareSource
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$74.13
Typical High
$91.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$251.19
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$275.42
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$57.54
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$57.54

Where Kentucky 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.

Kentucky· 17th of 51

$70.79

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.