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PML/RARA Fusion Gene Test

Illinois rates for HCPCS 81316

Looks for an abnormal joining of the PML and RARA genes in a blood or bone marrow sample. This fusion is the defining feature of acute promyelocytic leukemia, a form of leukemia that responds to particular treatment, so the test is used to confirm the diagnosis quickly and to check afterwards whether any disease remains.

Rates data updated July 2026.

How much does PML/RARA Fusion Gene Test cost?

$234

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $324 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$186$170 to $302
FacilityA hospital or hospital-owned outpatient department$324$214 to $427

How much rates vary

Facilitymedian $324 · 10th to 90th $178 to $562Professionalmedian $186 · 10th to 90th $158 to $479
$100$200$500$1K$2Kfacility $324professional $186

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
$169.82
Median
$323.59
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$177.83
Typical High
$426.58
BCBS
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$851.14
Typical High
$2,630.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$537.03
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$288.40
Typical High
$478.63
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$363.08
Typical High
$741.31
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$181.97
Typical High
$371.54

Where Illinois sits

The same service costs 3.5 times more in Vermont than in Washington, DC. 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.

Illinois· 23rd of 51

$234

VT $537DC $155

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.