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Genetic Test for Changes in a Single Gene

Pennsylvania rates for HCPCS 81352

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?

$282

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $282 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $631 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$269$214 to $309
FacilityA hospital or hospital-owned outpatient department$631$398 to $955

How much rates vary

Facilitymedian $631 · 10th to 90th $282 to $1,230Professionalmedian $269 · 10th to 90th $178 to $724
$200$500$1K$2Kfacility $631professional $269

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
$281.84
Median
$630.96
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$1,174.90
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,621.81
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$537.03
Typical High
$1,122.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$288.40
Typical High
$588.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$436.52
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$398.11
Typical High
$616.60
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$933.25
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$630.96
Typical High
$1,122.02
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$1,174.90
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$812.83
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$331.13
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$457.09

Where Pennsylvania 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.

Pennsylvania· 38th of 51

$282

AK $741DE $219

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.