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Fragile X Gene Test

Rhode Island 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?

$87.10

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $69.18 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 4 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$87.10$42.66 to $87.10
FacilityA hospital or hospital-owned outpatient department$69.18$66.07 to $251

How much rates vary

Facilitymedian $69 · 10th to 90th $58 to $331Professionalmedian $87 · 10th to 90th $40 to $87
$50$100$200facility $69professional $87

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$331.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$66.07
Typical High
$72.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$194.98
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$83.18

Where Rhode Island sits

The same service costs 3.0 times more in Alaska than in Washington, DC. 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.

Rhode Island· 10th of 51

$87.10

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.