go back

Genetic Test for Changes in a Single Gene

North Carolina rates for HCPCS 81351

A laboratory test that examines DNA from a blood or tissue sample to look for changes in one specific gene. The result is used to help confirm a diagnosis, assess risk, or guide treatment decisions, and is normally interpreted alongside personal and family medical history.

Rates data updated July 2026.

How much does Genetic Test for Changes in a Single Gene cost?

$575

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $575 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $851 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 6 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$513$513 to $661
FacilityA hospital or hospital-owned outpatient department$851$562 to $1,950

How much rates vary

Facilitymedian $851 · 10th to 90th $501 to $2,138Professionalmedian $513 · 10th to 90th $417 to $1,023
$500$1K$2Kfacility $851professional $513

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
$501.19
Median
$1,819.70
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$512.86
Typical High
$851.14
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,412.54
Typical High
$1,445.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$645.65
Typical High
$1,148.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$1,412.54
Typical High
$2,951.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$323.59
Typical High
$977.24
Medcost
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$575.44
Typical High
$933.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$758.58
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$389.05
Typical High
$707.95
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$4,786.30

Where North Carolina sits

The same service costs 3.4 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· 34th of 51

$575

AK $1,445DE $427

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.