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Fragile X Gene Test

New Jersey 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?

$44.67

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $44.67 for this service. The price depends on where it is billed: about $39.81 from a physician practice, and about $214 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$39.81$34.67 to $81.28
FacilityA hospital or hospital-owned outpatient department$214$87.10 to $10,965

How much rates vary

Facilitymedian $214 · 10th to 90th $66 to $20,417Professionalmedian $40 · 10th to 90th $28 to $87
$100$1K$10Kfacility $214professional $40

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
$87.10
Median
$87.10
Typical High
$194.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$23.99
Median
$43.65
Typical High
$43.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$9.77
Median
$17.78
Typical High
$17.78
AmeriHealth
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$158.49
Typical High
$2,398.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$158.49
Typical High
$275.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$60.26
Typical High
$85.11
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$74.13
Typical High
$83.18
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$4,570.88
Median
$15,488.17
Typical High
$26,915.35
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
United
Setting
Facility
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
United
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$33.88
Typical High
$57.54

Where New Jersey 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.

New Jersey· 48th of 51

$44.67

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.