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Genetic Test For A Specific Gene Change

Delaware rates for HCPCS 81404

This is a laboratory test that analyzes a particular gene to look for a specific genetic change linked to an inherited condition or a disease risk. Which gene is examined depends on the medical reason the test was ordered, such as a family history of a certain condition or a diagnosis that needs genetic confirmation. The analysis involves techniques of moderate technical complexity compared with simpler single-variant genetic checks.

Rates data updated July 2026.

How much does Genetic Test For A Specific Gene Change cost?

$186

Typical negotiated rate. In Delaware, July 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $316 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 4 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$186$174 to $229
FacilityA hospital or hospital-owned outpatient department$316$48.98 to $316

How much rates vary

Facilitymedian $316 · 10th to 90th $49 to $316Professionalmedian $186 · 10th to 90th $174 to $832
$50$100$200$500$1K$2Kfacility $316professional $186

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
$48.98
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$186.21
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$416.87
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$416.87

Where Delaware sits

The same service costs 3.5 times more in Alaska than in Rhode Island. 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.

Delaware· 49th of 51

$186

AK $617RI $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.