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Cancer-Related Gene Mutation Test

Kentucky rates for HCPCS 81311

This service is a genetic laboratory test that looks for specific mutations in a gene that is commonly altered in certain cancers. Results can help guide decisions about cancer treatment, including whether a particular targeted therapy is likely to work. The test is run on a tumor tissue sample.

Rates data updated October 2026.

How much does Cancer-Related Gene Mutation Test cost?

$178

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $295 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$178$132 to $295
FacilityA hospital or hospital-owned outpatient department$295$251 to $398

How much rates vary

Facilitymedian $295 · 10th to 90th $229 to $912Professionalmedian $178 · 10th to 90th $117 to $550
$100$200$500$1Kfacility $295professional $178

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
$239.88
Median
$251.19
Typical High
$323.59
Aetna
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$239.88
Typical High
$323.59
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$295.12
Typical High
$309.03
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$131.83
Typical High
$251.19
CareSource
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$398.11
Typical High
$416.87
CareSource
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$380.19
Typical High
$489.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$912.01
Typical High
$912.01
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$1,412.54
Typical High
$1,412.54
United
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$177.83
Typical High
$478.63
2 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
$112.20
Median
$120.23
Typical High
$162.18
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$44.67
Median
$47.86
Typical High
$64.57

Where Kentucky sits

The same service costs 3.8 times more in Alaska than in Alabama. 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.

Kentucky· 50th of 51

$178

AK $661AL $174

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.