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Breast Tumor Gene Test For Longer Hormone Therapy

Rhode Island rates for HCPCS 81518

A laboratory test run on breast tumor tissue that measures how active a set of genes is and turns the readings into a score. The score estimates the chance of the cancer returning in later years and how likely it is that continuing hormone-blocking treatment beyond the usual course would help. It uses tissue already removed at biopsy or surgery, so no new procedure is needed.

Rates data updated July 2026.

How much does Breast Tumor Gene Test For Longer Hormone Therapy cost?

$2,884

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $2,884 for this service. The price depends on where it is billed: about $2,884 from a physician practice, and about $5,754 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$2,884$2,692 to $2,884
FacilityA hospital or hospital-owned outpatient department$5,754$4,467 to $17,378

How much rates vary

Facilitymedian $5,754 · 10th to 90th $3,890 to $22,387Professionalmedian $2,884 · 10th to 90th $2,344 to $3,890
$2K$5K$10K$20Kfacility $5,754professional $2,884

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
$11,220.18
Median
$17,378.01
Typical High
$22,387.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$2,884.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,466.84
Typical High
$5,011.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$4,265.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$10,715.19
Typical High
$10,715.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,290.87
Typical High
$6,025.60
United
Setting
Facility
Modifier
Global
Typical Low
$4,677.35
Median
$4,677.35
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$2,344.23
Typical High
$5,623.41

Where Rhode Island sits

The same service costs 3.4 times more in Alaska than in Delaware. 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· 46th of 51

$2,884

AK $8,710DE $2,570

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.