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Fragile X Gene Test

North Carolina 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 North Carolina, July 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $182 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$51.29$45.71 to $85.11
FacilityA hospital or hospital-owned outpatient department$182$50.12 to $191

How much rates vary

Facilitymedian $182 · 10th to 90th $46 to $437Professionalmedian $51 · 10th to 90th $34 to $209
$10.0$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $182professional $51

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
$45.71
Median
$181.97
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$45.71
Typical High
$87.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$173.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$69.18
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$123.03
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$26.92
Typical High
$75.86
Medcost
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$58.88
Typical High
$104.71
Medcost
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$67.61
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$60.26
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$426.58

Where North Carolina 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.

North Carolina $57.54 · 33rd 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.