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Fragile X Gene Test

Maine 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?

$57.54

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $57.54 from a physician practice, and about $100 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 6 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$45.71 to $57.54
FacilityA hospital or hospital-owned outpatient department$100$57.54 to $178

How much rates vary

Facilitymedian $100 · 10th to 90th $58 to $331Professionalmedian $58 · 10th to 90th $34 to $69
$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $100professional $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
$93.33
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$45.71
Typical High
$87.10
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$165.96
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$24.55
Typical High
$37.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$57.54
Typical High
$57.54
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$67.61
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$371.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$57.54
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$87.10

Where Maine 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.

Maine $57.54 · 39th 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.