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Cancer-Related Gene Mutation Test, Blood Or Tissue

North Carolina rates for HCPCS 81305

This service is a genetic laboratory test that looks for specific mutations in a gene commonly altered in certain blood or bone marrow cancers. Results can help confirm a diagnosis and guide treatment decisions. The test is typically run on a blood or bone marrow sample.

Rates data updated October 2026.

How much does Cancer-Related Gene Mutation Test, Blood Or Tissue cost?

$170

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $380 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$162$115 to $209
FacilityA hospital or hospital-owned outpatient department$380$141 to $550

How much rates vary

Facilitymedian $380 · 10th to 90th $141 to $794Professionalmedian $162 · 10th to 90th $79 to $269
$100$200$500$1Kfacility $380professional $162

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$288.40
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$141.25
Typical High
$208.93
BCBS North Carolina
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$524.81
Typical High
$549.54
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$173.78
Typical High
$281.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$457.09
Typical High
$794.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$128.82
Typical High
$269.15
Medcost
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$208.93
Medcost
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$302.00
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$104.71
Typical High
$181.97
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$69.18
Median
$70.79
Typical High
$104.71
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$28.18
Typical High
$41.69
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$87.10
Median
$87.10
Typical High
$239.88

Where North Carolina sits

The same service costs 3.8 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· 27th of 51

$170

AK $398DE $105

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.