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Fragile X Gene Test

Massachusetts 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?

$67.61

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $67.61 for this service. The price depends on where it is billed: about $57.54 from a physician practice, and about $112 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 9 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$57.54$57.54 to $87.10
FacilityA hospital or hospital-owned outpatient department$112$91.20 to $162

How much rates vary

Facilitymedian $112 · 10th to 90th $60 to $186Professionalmedian $58 · 10th to 90th $45 to $129
$100.0$1.0K$10.0Kfacility $112professional $58

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
$57.54
Median
$107.15
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$87.10
Typical High
$169.82
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$165.96
Typical High
$269.15
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$112.20
Typical High
$162.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$36.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$79.43
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$60.26
Typical High
$147.91
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$81.28
Typical High
$97.72
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$95.50
Health New England
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$190.55
Typical High
$478.63
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$165.96
Typical High
$269.15
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$117.49

Where Massachusetts 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.

Massachusetts $67.61 · 21st 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.