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Breast Cancer Gene Activity Recurrence Test

Pennsylvania rates for HCPCS 81523

A laboratory test run on a sample of breast tumor tissue that measures how active a group of genes is inside the cancer cells. The pattern is turned into a score estimating the chance that the cancer will come back or spread elsewhere in the body. The result helps the patient and oncologist decide whether chemotherapy is likely to add benefit beyond hormone treatment.

Rates data updated July 2026.

How much does Breast Cancer Gene Activity Recurrence Test cost?

$3,311

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $3,311 for this service. The price depends on where it is billed: about $3,162 from a physician practice, and about $7,413 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 8 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$3,162$2,570 to $3,631
FacilityA hospital or hospital-owned outpatient department$7,413$4,677 to $10,715

How much rates vary

Facilitymedian $7,413 · 10th to 90th $3,311 to $14,454Professionalmedian $3,162 · 10th to 90th $2,089 to $8,913
$2K$5K$10K$20Kfacility $7,413professional $3,162

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
$3,311.31
Median
$7,413.10
Typical High
$13,803.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$3,162.28
Typical High
$13,803.84
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$18,620.87
Typical High
$26,302.68
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,818.38
Median
$5,248.07
Typical High
$11,481.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$3,388.44
Typical High
$8,709.64
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$5,128.61
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$3,890.45
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$4,466.84
Typical High
$7,244.36
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$7,413.10
Typical High
$13,803.84
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$3,162.28
Typical High
$13,803.84
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$4,265.80
Typical High
$9,549.93
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$4,265.80
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$3,890.45
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$2,344.23
Typical High
$5,754.40

Where Pennsylvania 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.

Pennsylvania· 33rd of 51

$3,311

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.