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Single-Gene Genetic Test

Massachusetts 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?

$603

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $1,202 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$603$490 to $603
FacilityA hospital or hospital-owned outpatient department$1,202$708 to $1,660

How much rates vary

Facilitymedian $1,202 · 10th to 90th $447 to $1,905Professionalmedian $603 · 10th to 90th $363 to $1,479
$200$500$1K$2Kfacility $1,202professional $603

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
$416.87
Median
$1,047.13
Typical High
$1,778.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$446.68
Typical High
$1,819.70
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$691.83
Typical High
$1,949.84
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$1,995.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,202.26
Typical High
$1,905.46
BCBS
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$467.74
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$724.44
Typical High
$1,258.93
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$2,754.23
Typical High
$7,079.46
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$870.96
Typical High
$1,023.29
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$1,096.48
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$691.83
Typical High
$1,949.84
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$724.44
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$602.56
Typical High
$1,348.96

Where Massachusetts 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.

Massachusetts· 24th of 51

$603

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.