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Fragile X Gene Test

Montana 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?

$85.11

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $89.13 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$85.11$70.79 to $97.72
FacilityA hospital or hospital-owned outpatient department$89.13$70.79 to $174

How much rates vary

Facilitymedian $89 · 10th to 90th $71 to $355Professionalmedian $85 · 10th to 90th $29 to $178
$100.0$1.0K$10.0K$100.0Kfacility $89professional $85

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
Professional
Modifier
Global
Typical Low
$66.07
Median
$87.10
Typical High
$380.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$354.81
Typical High
$87,096.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$97.72
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$85.11
Typical High
$177.83
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$85.11
Typical High
$177.83
Providence
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$114.82
Typical High
$389.05
Providence
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$91.20
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$57.54

Where Montana 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.

Montana $85.11 · 11th 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.