go back

Cancer-Related Gene Mutation Test

Vermont 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?

$363

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $363 from a physician practice, and about $295 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 5 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$363$209 to $363
FacilityA hospital or hospital-owned outpatient department$295$288 to $324

How much rates vary

Facilitymedian $295 · 10th to 90th $288 to $490Professionalmedian $363 · 10th to 90th $209 to $363
$200$500facility $295professional $363

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$363.08
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$346.74
Typical High
$446.68
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$338.84
Typical High
$645.65

Where Vermont 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.

Vermont· 8th of 51

$363

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.