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Single-Gene Genetic Test

Illinois rates for HCPCS 81296

A DNA test that focuses on one gene rather than scanning many at once. It is run in a specialist laboratory on a sample taken from the patient, and the finding contributes to a diagnosis or to a treatment decision.

Rates data updated October 2026.

How much does Single-Gene Genetic Test cost?

$288

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $275 from a physician practice, and about $631 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$275$170 to $372
FacilityA hospital or hospital-owned outpatient department$631$407 to $1,175

How much rates vary

Facilitymedian $631 · 10th to 90th $234 to $2,138Professionalmedian $275 · 10th to 90th $78 to $525
$100$200$500$1K$2K$5Kfacility $631professional $275

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
$275.42
Median
$524.81
Typical High
$1,023.29
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$138.04
Median
$245.47
Typical High
$512.86
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$54.95
Median
$97.72
Typical High
$204.17
Aetna
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$275.42
Typical High
$302.00
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$134.90
Median
$138.04
Typical High
$151.36
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$53.70
Median
$54.95
Typical High
$60.26
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$575.44
Typical High
$4,265.80
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$707.95
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$380.19
Typical High
$562.34
Hally Health
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$467.74
Typical High
$691.83
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
United
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$407.38
Typical High
$426.58
United
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$151.36
Typical High
$288.40

Where Illinois sits

The same service costs 6.6 times more in Texas than in Kentucky. 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.

Illinois· 20th of 51

$288

TX $891KY $135

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.