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Genetic Test For A Specific Gene Change

Tennessee 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?

$234

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $234 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 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$219$204 to $295
FacilityA hospital or hospital-owned outpatient department$417$245 to $912

How much rates vary

Facilitymedian $417 · 10th to 90th $204 to $1,175Professionalmedian $219 · 10th to 90th $166 to $398
$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
$204.17
Median
$416.87
Typical High
$1,174.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$218.78
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$275.42
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$562.34
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$169.82
Typical High
$380.19
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$2,041.74
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$281.84

Where Tennessee 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.

Tennessee· 35th of 51

$234

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.