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Genetic Test For A Specific Gene Change

Rhode Island 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?

$174

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $331 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 4 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 $204
FacilityA hospital or hospital-owned outpatient department$331$316 to $525

How much rates vary

Facilitymedian $331 · 10th to 90th $275 to $1,585Professionalmedian $174 · 10th to 90th $174 to $275
$200$500$1Kfacility $331professional $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$316.23
Typical High
$354.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$758.58
Typical High
$933.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$389.05
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$398.11

Where Rhode Island 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.

Rhode Island· 51st of 51

$174

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.