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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 October 2026.

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

$263

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $263 for this service. The price depends on where it is billed: about $263 from a physician practice, and about $447 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$263$245 to $324
FacilityA hospital or hospital-owned outpatient department$447$324 to $955

How much rates vary

Facilitymedian $447 · 10th to 90th $263 to $1,622Professionalmedian $263 · 10th to 90th $162 to $490
$200$500$1K$2K$5Kfacility $447professional $263

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$275.42
Typical High
$954.99
Aetna
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$263.03
Typical High
$275.42
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$128.82
Median
$131.83
Typical High
$138.04
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$51.29
Median
$52.48
Typical High
$54.95
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$1,659.59
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$251.19
Typical High
$776.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$537.03
Typical High
$977.24
Cigna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$309.03
Typical High
$489.78
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$426.58
Typical High
$426.58
Geisinger
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Geisinger
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$354.81
Typical High
$630.96
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$891.25
Typical High
$1,905.46
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$954.99
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$263.03
Typical High
$275.42
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$128.82
Median
$131.83
Typical High
$138.04
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$51.29
Median
$52.48
Typical High
$54.95
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$323.59
Median
$416.87
Typical High
$794.33
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$354.81
Typical High
$354.81
United
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$323.59
Typical High
$389.05
United
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$194.98
Typical High
$389.05

Where Pennsylvania sits

The same service costs 4.2 times more in Alaska than in Alabama. 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

$263

AK $724AL $174

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.