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Genetic Test For A Prognostic Cancer Mutation

Maryland rates for HCPCS 81263

A molecular blood or bone marrow test that looks for a specific genetic mutation acquired within cancer cells themselves, rather than examining the gene-rearrangement pattern shared among a group of cells. It is used in certain blood cancers to help provide information about how the disease is expected to behave and to help guide treatment decisions. Results are interpreted alongside other clinical findings.

Rates data updated July 2026.

How much does Genetic Test For A Prognostic Cancer Mutation cost?

$219

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $219 for this service. Most negotiated rates run $204 to $263.

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.

How much rates vary

Facilitymedian $407 · 10th to 90th $263 to $447Professionalmedian $219 · 10th to 90th $145 to $525
$100$200$500$1Kfacility $407professional $219

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
$263.03
Median
$407.38
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$218.78
Typical High
$630.96
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$524.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$354.81
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$169.82
Typical High
$275.42
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$288.40
Typical High
$288.40

Where Maryland sits

The same service costs 3.3 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.

Maryland· 49th of 51

$219

AK $661DE $200

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.