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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 July 2026.

How much does Single-Gene Genetic Test cost?

$288

Typical negotiated rate. In Pennsylvania, July 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 $501 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 8 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$275$141 to $288
FacilityA hospital or hospital-owned outpatient department$501$288 to $851

How much rates vary

Facilitymedian $501 · 10th to 90th $251 to $1,202Professionalmedian $275 · 10th to 90th $71 to $794
$100$200$500$1K$2Kfacility $501professional $275

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
$251.19
Median
$524.81
Typical High
$1,202.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$275.42
Typical High
$1,202.26
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$549.54
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$218.78
Typical High
$758.58
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$446.68
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$524.81
Typical High
$851.14
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$501.19
Typical High
$1,148.15
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$275.42
Typical High
$1,202.26
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$223.87
Typical High
$338.84
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$338.84
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$338.84
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$457.09

Where Pennsylvania sits

The same service costs 8.3 times more in Alaska than in Vermont. 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· 25th of 51

$288

AK $759VT $91.20

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.