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Single-Gene Molecular Test

Pennsylvania rates for HCPCS 81252

A laboratory test that examines the DNA of one gene in a sample from the patient and reports whether particular changes are present. It is ordered when a specific gene is in question, and the result is read together with the clinical findings.

Rates data updated July 2026.

How much does Single-Gene Molecular Test cost?

$120

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $214 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$85.11$81.28 to $158
FacilityA hospital or hospital-owned outpatient department$214$120 to $302

How much rates vary

Facilitymedian $214 · 10th to 90th $85 to $380Professionalmedian $85 · 10th to 90th $79 to $245
$50$100$200$500facility $214professional $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
$85.11
Median
$213.80
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$363.08
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$501.19
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$165.96
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$107.15
Typical High
$229.09
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$131.83
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$288.40
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$239.88
Typical High
$363.08
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$363.08
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$112.20
Typical High
$251.19
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$112.20
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$100.00
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$60.26
Typical High
$151.36

Where Pennsylvania 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.

Pennsylvania· 17th of 51

$120

AK $229DC $75.86

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.