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Breast Tumor Gene Expression Risk Score

South Carolina rates for HCPCS 81520

A test carried out on breast tumor tissue removed at surgery or biopsy that measures how active a group of genes is inside the tumor and combines the readings into a single score. The score estimates how likely the cancer is to return, and it is used along with other findings to decide how much treatment is needed after surgery.

Rates data updated July 2026.

How much does Breast Tumor Gene Expression Risk Score cost?

$1,995

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $1,995 for this service. The price depends on where it is billed: about $1,950 from a physician practice, and about $3,548 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$1,950$1,950 to $2,042
FacilityA hospital or hospital-owned outpatient department$3,548$2,188 to $7,943

How much rates vary

Facilitymedian $3,548 · 10th to 90th $1,950 to $12,023Professionalmedian $1,950 · 10th to 90th $1,660 to $2,630
$1K$2K$5K$10Kfacility $3,548professional $1,950

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
$1,949.84
Median
$6,165.95
Typical High
$12,022.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,238.72
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$3,162.28
Typical High
$3,388.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$2,691.53
Typical High
$5,248.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,786.30
Median
$8,317.64
Typical High
$14,454.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,479.11
Typical High
$3,019.95
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$2,344.23
Typical High
$3,890.45
United
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$2,511.89
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,548.82
Typical High
$3,090.30

Where South Carolina sits

The same service costs 3.3 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.

South Carolina· 43rd of 51

$1,995

AK $5,623DE $1,698

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.