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Cancer-Related Gene Mutation Test

North Carolina 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?

$269

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $646 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$269$195 to $363
FacilityA hospital or hospital-owned outpatient department$646$245 to $912

How much rates vary

Facilitymedian $646 · 10th to 90th $234 to $1,349Professionalmedian $269 · 10th to 90th $151 to $575
$200$500$1Kfacility $646professional $269

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
$234.42
Median
$234.42
Typical High
$489.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$234.42
Typical High
$354.81
BCBS North Carolina
Setting
Facility
Modifier
None
Typical Low
$660.69
Median
$812.83
Typical High
$812.83
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$269.15
Typical High
$676.08
Cigna
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$776.25
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$218.78
Typical High
$457.09
Medcost
Setting
Facility
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$354.81
Medcost
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$512.86
United
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$177.83
Typical High
$302.00
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
$114.82
Median
$117.49
Typical High
$177.83
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$45.71
Median
$47.86
Typical High
$70.79
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$147.91
Median
$147.91
Typical High
$407.38

Where North Carolina 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.

North Carolina· 32nd of 51

$269

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.