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Genetic Test For A Specific Gene Change

Illinois 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?

$224

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $224 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $427 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 5 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$214$174 to $245
FacilityA hospital or hospital-owned outpatient department$427$282 to $562

How much rates vary

Facilitymedian $427 · 10th to 90th $234 to $813Professionalmedian $214 · 10th to 90th $3 to $447
$10$100$1Kfacility $427professional $214

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
$223.87
Median
$426.58
Typical High
$588.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$223.87
Typical High
$512.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$954.99
Typical High
$3,467.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$190.55
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$588.84
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$331.13
Typical High
$467.74
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$436.52
Typical High
$831.76
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$275.42

Where Illinois 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.

Illinois· 40th of 51

$224

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.