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Genetic Test For A Specific Gene Change

New Jersey 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 New Jersey, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $871 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$174$174 to $229
FacilityA hospital or hospital-owned outpatient department$871$363 to $1,660

How much rates vary

Facilitymedian $871 · 10th to 90th $251 to $7,079Professionalmedian $174 · 10th to 90th $166 to $316
$200$500$1K$2K$5K$10K$20Kfacility $871professional $174

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
$354.81
Median
$933.25
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$186.21
Typical High
$316.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$602.56
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$295.12
Typical High
$602.56
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$446.68
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$275.42
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$288.40

Where New Jersey 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.

New Jersey· 42nd 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.