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Genetic Test For A Specific Gene Change

Iowa 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?

$295

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $295 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $490 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 8 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 $692
FacilityA hospital or hospital-owned outpatient department$490$275 to $724

How much rates vary

Facilitymedian $490 · 10th to 90th $214 to $794Professionalmedian $269 · 10th to 90th $166 to $1,820
$200$500$1Kfacility $490professional $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
$213.80
Median
$616.60
Typical High
$1,023.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$239.88
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$524.81
Typical High
$660.69
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$478.63
Typical High
$562.34
Medica
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$331.13
Typical High
$707.95
Medica
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$281.84
Typical High
$1,096.48
Midlands
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$363.08
Typical High
$363.08
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$295.12
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$630.96
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$691.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42

Where Iowa 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.

Iowa· 14th of 51

$295

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.