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Fragile X Gene Test

Ohio 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?

$53.70

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $45.71 from a physician practice, and about $77.62 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 8 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$45.71$30.90 to $60.26
FacilityA hospital or hospital-owned outpatient department$77.62$57.54 to $126

How much rates vary

Facilitymedian $78 · 10th to 90th $47 to $229Professionalmedian $46 · 10th to 90th $23 to $102
$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $78professional $46

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
$46.77
Median
$97.72
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$46.77
Typical High
$138.04
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$60.26
Typical High
$104.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$29.51
Typical High
$79.43
CareSource
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$66.07
Typical High
$79.43
CareSource
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$331.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$39.81
Typical High
$128.82
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$83.18
Typical High
$602.56
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$30.90
Typical High
$114.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$51.29
Typical High
$61.66
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$63.10
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$57.54
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$79.43

Where Ohio 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.

Ohio $53.70 · 41st 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.