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Gene Activity Test For Lung Scarring

South Dakota rates for HCPCS 81554

A laboratory test performed on small pieces of lung tissue that measures the activity of a large set of genes and turns the pattern into a single categorical answer. The result helps doctors work out whether a particular scarring pattern is present in the lungs, so a diagnosis can often be reached without a larger surgical lung biopsy.

Rates data updated July 2026.

How much does Gene Activity Test For Lung Scarring cost?

$9,120

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $9,120 for this service. The price depends on where it is billed: about $6,310 from a physician practice, and about $10,471 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 6 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$6,310$4,266 to $12,589
FacilityA hospital or hospital-owned outpatient department$10,471$10,471 to $10,471

How much rates vary

Facilitymedian $10,471 · 10th to 90th $6,166 to $10,471Professionalmedian $6,310 · 10th to 90th $3,715 to $13,183
$5K$10Kfacility $10,471professional $6,310

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
$3,890.45
Median
$6,309.57
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$4,265.80
Typical High
$5,248.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10,471.29
Median
$10,471.29
Typical High
$10,471.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7,585.78
Median
$10,471.29
Typical High
$13,182.57
Medica
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$6,165.95
Typical High
$10,000.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$2,818.38
Median
$2,818.38
Typical High
$26,915.35
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$7,943.28
Median
$12,589.25
Typical High
$14,791.08
United
Setting
Professional
Modifier
Global
Typical Low
$2,290.87
Median
$3,311.31
Typical High
$7,244.36
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32

Where South Dakota sits

The same service costs 3.4 times more in Alaska than in Nebraska. 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 Dakota· 2nd of 51

$9,120

AK $12,303NE $3,631

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.