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Cancer-Related Gene Mutation Test

New York 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 July 2026.

How much does Cancer-Related Gene Mutation Test cost?

$295

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $468 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$240$162 to $355
FacilityA hospital or hospital-owned outpatient department$468$295 to $676

How much rates vary

Facilitymedian $468 · 10th to 90th $209 to $813Professionalmedian $240 · 10th to 90th $117 to $575
$200$500$1Kfacility $468professional $240

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
$512.86
Typical High
$812.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$239.88
Typical High
$537.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$776.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$575.44
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$295.12
Typical High
$295.12
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$295.12
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$630.96
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$371.54
Typical High
$1,071.52
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$338.84
Typical High
$794.33
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$245.47
Typical High
$524.81
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$281.84
Typical High
$524.81
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$380.19
Typical High
$1,548.82
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$295.12
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$295.12
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$251.19
Typical High
$645.65
Univera
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$213.80
Typical High
$363.08
Univera
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$281.84
Typical High
$588.84

Where New York sits

The same service costs 3.3 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· 19th of 51

$295

AK $661DE $200

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.