go back

Single-Gene Genetic Test

North Carolina 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?

$479

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $479 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $525 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$479$398 to $617
FacilityA hospital or hospital-owned outpatient department$525$479 to $891

How much rates vary

Facilitymedian $525 · 10th to 90th $457 to $1,995Professionalmedian $479 · 10th to 90th $275 to $851
$500$1K$2Kfacility $525professional $479

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
$380.19
Median
$524.81
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$478.63
Typical High
$794.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,348.96
Typical High
$1,584.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$537.03
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$1,318.26
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$295.12
Typical High
$831.76
Medcost
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$537.03
Typical High
$891.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$707.95
Typical High
$724.44
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$363.08
Typical High
$630.96
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$2,818.38
Typical High
$2,818.38
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$4,466.84

Where North Carolina 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.

North Carolina· 46th of 51

$479

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.