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Single-Gene Genetic Test

Pennsylvania 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?

$275

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $263 from a physician practice, and about $339 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$263$204 to $288
FacilityA hospital or hospital-owned outpatient department$339$275 to $589

How much rates vary

Facilitymedian $339 · 10th to 90th $234 to $1,023Professionalmedian $263 · 10th to 90th $141 to $347
$100$1K$10Kfacility $339professional $263

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
$251.19
Median
$275.42
Typical High
$977.24
Aetna
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$275.42
Typical High
$288.40
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$134.90
Median
$138.04
Typical High
$144.54
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$53.70
Median
$54.95
Typical High
$57.54
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$263.03
Typical High
$316.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$549.54
Typical High
$1,023.29
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$316.23
Typical High
$524.81
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$446.68
Typical High
$446.68
Geisinger
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Geisinger
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$501.19
Typical High
$851.14
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$275.42
Typical High
$1,148.15
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$275.42
Typical High
$288.40
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$134.90
Median
$138.04
Typical High
$144.54
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$53.70
Median
$54.95
Typical High
$57.54
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$234.42
Typical High
$831.76
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$338.84
United
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$338.84
Typical High
$407.38
United
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$154.88
Typical High
$389.05

Where Pennsylvania 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.

Pennsylvania· 22nd of 51

$275

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.