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Genetic Marker Analysis, Blood Or Tissue

North Carolina 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?

$151

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $151 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $182 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 6 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$138$138 to $182
FacilityA hospital or hospital-owned outpatient department$182$148 to $398

How much rates vary

Facilitymedian $182 · 10th to 90th $138 to $575Professionalmedian $138 · 10th to 90th $89 to $234
$100$200$500facility $182professional $138

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
$138.04
Median
$165.96
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$138.04
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$616.60
Typical High
$616.60
BCBS
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$181.97
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$380.19
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$95.50
Typical High
$234.42
Medcost
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$165.96
Typical High
$302.00
Medcost
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$104.71
Typical High
$223.87
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,288.25

Where North Carolina 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.

North Carolina· 36th of 51

$151

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.