go back

Gene Test Guiding Chemotherapy Dosing

North Carolina rates for HCPCS 81346

A laboratory test that examines one particular gene in a blood sample for specific known variations that change how the body handles a chemotherapy medicine. People carrying certain versions clear the medicine faster or slower than usual, which alters how much benefit and how much side effect a standard dose produces. The result helps the treating team set the dose or choose between medicines; it is not used to diagnose a condition.

Rates data updated October 2026.

How much does Gene Test Guiding Chemotherapy Dosing cost?

$174

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $380 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$174$141 to $263
FacilityA hospital or hospital-owned outpatient department$380$145 to $537

How much rates vary

Facilitymedian $380 · 10th to 90th $141 to $794Professionalmedian $174 · 10th to 90th $87 to $457
$100$200$500$1Kfacility $380professional $174

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
$141.25
Median
$141.25
Typical High
$288.40
Aetna
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$141.25
Typical High
$194.98
BCBS North Carolina
Setting
Facility
Modifier
None
Typical Low
$389.05
Median
$524.81
Typical High
$524.81
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$190.55
Typical High
$549.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$457.09
Typical High
$794.33
Cigna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$123.03
Typical High
$245.47
Medcost
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$208.93
Medcost
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$302.00
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$104.71
Typical High
$181.97
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
$67.61
Median
$69.18
Typical High
$95.50
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$28.18
Typical High
$38.90
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$87.10
Median
$87.10
Typical High
$239.88

Where North Carolina sits

The same service costs 3.7 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.

North Carolina· 25th of 51

$174

AK $389DE $105

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.