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Single-Gene Genetic Test

New Jersey 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 New Jersey, July 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $1,000 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$479$363 to $513
FacilityA hospital or hospital-owned outpatient department$1,000$794 to $2,818

How much rates vary

Facilitymedian $1,000 · 10th to 90th $603 to $6,026Professionalmedian $479 · 10th to 90th $316 to $741
$200$500$1K$2K$5K$10K$20Kfacility $1,000professional $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
$776.25
Median
$794.33
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,318.26
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$478.63
Typical High
$1,071.52
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$630.96
Typical High
$1,148.15
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$602.56
Typical High
$1,230.27
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$363.08
Typical High
$630.96

Where New Jersey 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.

New Jersey· 36th 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.