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Genetic Test For A Gene Linked To Sickle Cell Disease

Pennsylvania rates for HCPCS 81364

A genetic blood test that examines the gene associated with sickle cell disease and beta thalassemia, two inherited conditions affecting red blood cells and the hemoglobin they carry. It looks for a change in this gene that can cause or contribute to these conditions. It may be used to confirm a diagnosis, guide family planning, or evaluate a newborn or family member of someone already diagnosed.

Rates data updated July 2026.

How much does Genetic Test For A Gene Linked To Sickle Cell Disease cost?

$275

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $263 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$263$214 to $302
FacilityA hospital or hospital-owned outpatient department$631$398 to $891

How much rates vary

Facilitymedian $631 · 10th to 90th $275 to $1,349Professionalmedian $263 · 10th to 90th $178 to $676
$200$500$1K$2Kfacility $631professional $263

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
$275.42
Median
$630.96
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$1,148.15
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,584.89
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$537.03
Typical High
$1,096.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$275.42
Typical High
$562.34
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$426.58
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$371.54
Typical High
$616.60
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$977.24
Typical High
$1,905.46
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$630.96
Typical High
$1,288.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$269.15
Typical High
$1,148.15
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$354.81
Typical High
$794.33
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$323.59
Typical High
$389.05
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$489.78

Where Pennsylvania sits

The same service costs 3.3 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

$275

AK $724DE $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.