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Single-Gene Genetic Test

Illinois rates for HCPCS 81249

Examination in a specialist laboratory of the DNA of one gene taken from a patient sample, reported as whether particular changes are present in that gene. The finding supports a diagnosis or a treatment decision rather than answering the question by itself.

Rates data updated July 2026.

How much does Single-Gene Genetic Test cost?

$513

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $490 from a physician practice, and about $933 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 5 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$490$389 to $575
FacilityA hospital or hospital-owned outpatient department$933$617 to $1,230

How much rates vary

Facilitymedian $933 · 10th to 90th $513 to $1,660Professionalmedian $490 · 10th to 90th $3 to $912
$10$100$1Kfacility $933professional $490

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
$489.78
Median
$933.25
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$512.86
Typical High
$1,122.02
BCBS
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$2,089.30
Typical High
$7,585.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$416.87
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,412.54
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$724.44
Typical High
$1,000.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$812.83
Typical High
$1,202.26
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$1,202.26
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$363.08
Typical High
$602.56

Where Illinois sits

The same service costs 3.4 times more in Alaska than in Delaware. 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.

Illinois· 39th of 51

$513

AK $1,349DE $398

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.