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Fragile X Gene Test

South Dakota 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 South Dakota, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $110 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$85.11$44.67 to $110
FacilityA hospital or hospital-owned outpatient department$110$110 to $110

How much rates vary

Facilitymedian $110 · 10th to 90th $65 to $110Professionalmedian $85 · 10th to 90th $29 to $135
$50$100$200facility $110professional $85

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
$39.81
Median
$64.57
Typical High
$64.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$77.62
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$109.65
Typical High
$134.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$64.57
Typical High
$346.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$288.40
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$131.83
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$75.86
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54

Where South Dakota 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.

South Dakota· 2nd 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.