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Gene Test For Thiopurine Drug Safety

New York rates for HCPCS 81306

A test that checks for common inherited changes in a gene controlling how the body breaks down thiopurine medicines, which are used for leukemia, inflammatory bowel disease, and some autoimmune conditions. People carrying these changes clear the drug slowly and can suffer dangerous drops in blood counts at a standard dose. The result helps a doctor set a safe starting dose.

Rates data updated July 2026.

How much does Gene Test For Thiopurine Drug Safety cost?

$288

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $490 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$234$158 to $347
FacilityA hospital or hospital-owned outpatient department$490$288 to $692

How much rates vary

Facilitymedian $490 · 10th to 90th $240 to $794Professionalmedian $234 · 10th to 90th $117 to $575
$200$500$1Kfacility $490professional $234

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
$239.88
Median
$501.19
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$234.42
Typical High
$524.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$758.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$588.84
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$288.40
Typical High
$288.40
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$288.40
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$616.60
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$363.08
Typical High
$1,047.13
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$794.33
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$549.54
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$524.81
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$380.19
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$288.40
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$288.40
Typical High
$436.52
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$245.47
Typical High
$630.96
Univera
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$309.03
Typical High
$363.08
Univera
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$288.40
Typical High
$691.83

Where New York sits

The same service costs 3.4 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.

New York· 23rd of 51

$288

AK $661DE $195

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.