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Genetic Test For A Specific Gene Change

West Virginia 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?

$269

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $759 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 $234
FacilityA hospital or hospital-owned outpatient department$759$269 to $1,230

How much rates vary

Facilitymedian $759 · 10th to 90th $269 to $3,631Professionalmedian $219 · 10th to 90th $186 to $234
$200$500$1K$2Kfacility $759professional $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
$269.15
Median
$758.58
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$218.78
Typical High
$234.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$331.13
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$831.76
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$1,318.26
Typical High
$1,318.26
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$316.23
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$138.04
Typical High
$302.00

Where West Virginia 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.

West Virginia· 26th of 51

$269

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.