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Genetic Test For A Specific Gene Change

Montana 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?

$372

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $372 for this service. The price depends on where it is billed: about $355 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 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$355$174 to $417
FacilityA hospital or hospital-owned outpatient department$427$355 to $646

How much rates vary

Facilitymedian $427 · 10th to 90th $347 to $1,549Professionalmedian $355 · 10th to 90th $166 to $1,820
$200$1K$5K$20K$100Kfacility $427professional $355

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
$602.56
Median
$602.56
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$1,819.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$954.99
Typical High
$81,283.05
BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$467.74
Typical High
$1,548.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$416.87
Typical High
$851.14
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$416.87
Typical High
$851.14
Providence
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$537.03
Typical High
$1,548.82
Providence
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$275.42

Where Montana 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.

Montana· 5th of 51

$372

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.