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Genetic Marker Analysis, Blood Or Tissue

Massachusetts 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 July 2026.

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

$174

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $363 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 9 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$174$151 to $178
FacilityA hospital or hospital-owned outpatient department$363$234 to $501

How much rates vary

Facilitymedian $363 · 10th to 90th $141 to $589Professionalmedian $174 · 10th to 90th $123 to $427
$100$200$500$1K$2Kfacility $363professional $174

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
$141.25
Median
$398.11
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$512.86
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$562.34
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$575.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$363.08
Typical High
$524.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$223.87
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$186.21
Typical High
$446.68
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$251.19
Typical High
$295.12
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$316.23
Health New England
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$199.53
Typical High
$199.53
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$562.34
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$389.05

Where Massachusetts 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.

Massachusetts· 29th of 51

$174

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.