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Fragile X Gene Test

Pennsylvania 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 Pennsylvania, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $132 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 11 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$53.70$45.71 to $87.10
FacilityA hospital or hospital-owned outpatient department$132$67.61 to $182

How much rates vary

Facilitymedian $132 · 10th to 90th $49 to $331Professionalmedian $54 · 10th to 90th $45 to $129
$10.0$100.0$1.0K$10.0Kfacility $132professional $54

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
$48.98
Median
$141.25
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$53.70
Typical High
$169.82
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$67.61
Typical High
$1,819.70
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$281.84
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$93.33
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$60.26
Typical High
$128.82
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$74.13
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$87.10
Typical High
$125.89
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$138.04
Typical High
$512.86
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$64.57
Typical High
$134.90
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$141.25
Typical High
$251.19
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$54.95
Typical High
$204.17
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$257.04
Typical High
$524.81
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$57.54
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$85.11

Where Pennsylvania 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.

Pennsylvania $85.11 · 12th 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.