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Genetic Test For A Specific Gene Change

Maine 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?

$275

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $275 from a physician practice, and about $447 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 6 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$275$224 to $275
FacilityA hospital or hospital-owned outpatient department$447$275 to $1,230

How much rates vary

Facilitymedian $447 · 10th to 90th $275 to $1,698Professionalmedian $275 · 10th to 90th $166 to $331
$100$200$500$1Kfacility $447professional $275

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
$275.42
Median
$275.42
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$223.87
Typical High
$302.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$1,698.24
Typical High
$1,819.70
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$275.42
Typical High
$275.42
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$331.13
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$1,230.27
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$275.42
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$275.42
Typical High
$426.58

Where Maine 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.

Maine· 20th of 51

$275

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.