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Genetic Test For A Specific Gene Change

Ohio 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?

$245

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $417 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 8 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$132 to $263
FacilityA hospital or hospital-owned outpatient department$417$275 to $692

How much rates vary

Facilitymedian $417 · 10th to 90th $224 to $1,096Professionalmedian $219 · 10th to 90th $110 to $525
$100$200$500$1K$2Kfacility $417professional $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
$223.87
Median
$562.34
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$218.78
Typical High
$676.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$288.40
Typical High
$501.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$371.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$316.23
Typical High
$389.05
CareSource
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$363.08
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$616.60
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$363.08
Typical High
$1,584.89
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$549.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$245.47
Typical High
$302.00
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$302.00
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$275.42
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$380.19

Where Ohio 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.

Ohio· 33rd of 51

$245

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.