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Genetic Test For A Prognostic Cancer Mutation

Maine 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 October 2026.

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

$240

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $372 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$148 to $240
FacilityA hospital or hospital-owned outpatient department$372$288 to $437

How much rates vary

Facilitymedian $372 · 10th to 90th $282 to $1,479Professionalmedian $178 · 10th to 90th $117 to $398
$100$200$500$1K$2Kfacility $372professional $178

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$239.88
Typical High
$239.88
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$389.05
Typical High
$1,479.11
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$147.91
Typical High
$190.55
Cigna
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$676.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$295.12
Typical High
$295.12
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$295.12
Typical High
$707.95
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
United
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$239.88
Typical High
$707.95

Where Maine sits

The same service costs 3.8 times more in Alaska than in Alabama. 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.

Maine· 39th of 51

$240

AK $661AL $174

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.