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Fragile X Gene Test

Michigan 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 October 2026.

How much does Fragile X Gene Test cost?

$53.70

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $53.70 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$42.66 to $57.54
FacilityA hospital or hospital-owned outpatient department$53.70$53.70 to $75.86

How much rates vary

Facilitymedian $54 · 10th to 90th $43 to $112Professionalmedian $54 · 10th to 90th $34 to $71
$10$20$50$100$200$500facility $54professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$85.11
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$26.92
Typical High
$42.66
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$10.96
Typical High
$16.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$56.23
Typical High
$85.11
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$28.18
Typical High
$33.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$11.22
Typical High
$13.49
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$60.26
Typical High
$107.15
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$42.66
Typical High
$42.66
CareSource
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
CareSource
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$63.10
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$39.81
Typical High
$77.62
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$158.49
Health Alliance Plan
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$26.92
Typical High
$42.66
Health Alliance Plan
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$10.96
Typical High
$16.98
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$75.86
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
Priority Health
Setting
Professional
Modifier
None
Typical Low
$26.30
Median
$57.54
Typical High
$77.62
United
Setting
Facility
Modifier
None
Typical Low
$33.88
Median
$51.29
Typical High
$69.18
United
Setting
Professional
Modifier
None
Typical Low
$23.99
Median
$33.88
Typical High
$57.54

Where Michigan sits

The same service costs 3.4 times more in Alaska than in Nebraska. 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.

Michigan· 38th of 51

$53.70

AK $129NE $38.02

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.