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Genetic Test for Changes in a Single Gene

New York 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?

$631

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $631 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $1,023 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 9 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$347 to $759
FacilityA hospital or hospital-owned outpatient department$1,023$646 to $1,479

How much rates vary

Facilitymedian $1,023 · 10th to 90th $447 to $1,778Professionalmedian $513 · 10th to 90th $257 to $1,230
$500$1K$2Kfacility $1,023professional $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
$524.81
Median
$1,096.48
Typical High
$1,778.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$524.81
Typical High
$1,148.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$1,659.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$1,230.27
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$645.65
Typical High
$645.65
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$645.65
Typical High
$645.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$1,380.38
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$812.83
Typical High
$2,344.23
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$831.76
Typical High
$1,778.28
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$537.03
Typical High
$1,230.27
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$616.60
Typical High
$758.58
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$831.76
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$645.65
Typical High
$1,148.15
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$645.65
Typical High
$954.99
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$537.03
Typical High
$1,412.54
Univera
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$467.74
Typical High
$758.58
Univera
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$616.60
Typical High
$1,148.15

Where New York 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.

New York· 29th of 51

$631

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.