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Genetic Marker Analysis, Blood Or Tissue

Iowa rates for HCPCS 81264

This service is a laboratory test that analyzes a blood or tissue sample for a specific genetic marker to detect an abnormal clonal population of cells - a group of cells that all arose from a single abnormal cell - which can be a sign of certain cancers. Results help a doctor diagnose or monitor conditions such as blood cancers. The sample is processed in a specialized genetics laboratory.

Rates data updated October 2026.

How much does Genetic Marker Analysis, Blood Or Tissue cost?

$186

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $295 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$123 to $331
FacilityA hospital or hospital-owned outpatient department$295$209 to $417

How much rates vary

Facilitymedian $295 · 10th to 90th $174 to $457Professionalmedian $178 · 10th to 90th $105 to $661
$100$200$500facility $295professional $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
$134.90
Median
$363.08
Typical High
$489.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$134.90
Typical High
$208.93
Cigna
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$331.13
Typical High
$416.87
Hally Health
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$213.80
Typical High
$316.23
Medica
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$295.12
Typical High
$416.87
Medica
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$208.93
Typical High
$870.96
Midlands
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$229.09
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$186.21
Typical High
$371.54
United
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$446.68
United
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$380.19
Wellmark
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$67.61
Median
$67.61
Typical High
$104.71
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$26.92
Median
$26.92
Typical High
$41.69

Where Iowa 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.

Iowa· 20th of 51

$186

AK $389DE $115

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.