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Genetic Marker Analysis, Blood Or Tissue

Pennsylvania 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?

$148

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $389 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$141$135 to $162
FacilityA hospital or hospital-owned outpatient department$389$209 to $513

How much rates vary

Facilitymedian $389 · 10th to 90th $148 to $832Professionalmedian $141 · 10th to 90th $107 to $407
$100.0$1.0K$10.0Kfacility $389professional $141

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
$147.91
Median
$389.05
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$616.60
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,000.00
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$186.21
Typical High
$389.05
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$223.87
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$263.03
Typical High
$436.52
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$489.78
Typical High
$794.33
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$389.05
Typical High
$758.58
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$616.60
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$467.74
Typical High
$1,202.26
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$173.78
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$104.71
Typical High
$257.04

Where Pennsylvania sits

The same service costs 3.4 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $148 · 40th of 51
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.