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Prader-Willi/Angelman Genetic Test

Ohio rates for HCPCS 81331

This service is a genetic laboratory test that looks at a specific pattern of gene activity to help diagnose Prader-Willi syndrome or Angelman syndrome, two different inherited conditions that affect development. It is typically ordered when a child shows developmental delay, low muscle tone, feeding difficulties, or other features suggestive of one of these conditions. The test is run on a blood sample.

Rates data updated July 2026.

How much does Prader-Willi/Angelman Genetic Test cost?

$47.86

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $40.74 from a physician practice, and about $69.18 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 8 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$40.74$28.18 to $52.48
FacilityA hospital or hospital-owned outpatient department$69.18$51.29 to $112

How much rates vary

Facilitymedian $69 · 10th to 90th $42 to $123Professionalmedian $41 · 10th to 90th $20 to $115
$20.0$50.0$100.0$200.0$500.0facility $69professional $41

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
$40.74
Median
$91.20
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$41.69
Typical High
$123.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$53.70
Typical High
$93.33
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$26.30
Typical High
$69.18
CareSource
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
CareSource
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$67.61
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$30.90
Typical High
$114.82
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$67.61
Typical High
$208.93
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$27.54
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$45.71
Typical High
$54.95
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$57.54
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$51.29
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$30.90
Typical High
$70.79

Where Ohio sits

The same service costs 3.0 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Ohio $47.86 · 38th of 51
AK $115MD $38.02

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.