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Genetic Test For A Specific Gene Change

Kentucky 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?

$219

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $275 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$219$110 to $251
FacilityA hospital or hospital-owned outpatient department$275$224 to $417

How much rates vary

Facilitymedian $275 · 10th to 90th $219 to $661Professionalmedian $219 · 10th to 90th $110 to $380
$100$200$500$1Kfacility $275professional $219

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
$218.78
Median
$223.87
Typical High
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$218.78
Typical High
$380.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$275.42
Typical High
$288.40
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$275.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$524.81
CareSource
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$831.76
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$1,318.26
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$275.42
Typical High
$1,659.59
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$275.42

Where Kentucky 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.

Kentucky· 43rd of 51

$219

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.