Based on public Medicaid payment data.
Average Medicaid Molecular & Genetic Testing Payments
Typical Medicaid Molecular & Genetic Testing reimbursement across 457 cities
Avg. Medicaid Paid
$107.98
Price Range
$0.00 – $1,804
Total Claims
7.1M
Cities
457
Typical Payment Range
Typical Medicaid Molecular & Genetic Testing payments fall between $45.12 and $259.78 per claim (median: $127.02). The top 10% of payments exceed $446.97.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Advanced laboratory tests that analyze DNA, RNA, or proteins to diagnose genetic disorders, identify infectious agents, and guide personalized treatment.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Oakland, CA | $191.75 | $191.75 – $191.75 | 3,077 | 1 |
| Cleveland, OH | $227.94 | $62.86 – $360.53 | 3,074 | 4 |
| Rochester, MN | $152.26 | $58.12 – $153.13 | 2,963 | 2 |
| Fresno, CA | $4.15 | $3.76 – $30.45 | 2,899 | 2 |
| Allen Park, MI | $92.53 | $92.53 – $92.53 | 2,873 | 1 |
| Miami, FL | $168.29 | $0.00 – $909.18 | 2,833 | 5 |
| Milwaukee, WI | $389.22 | $109.11 – $556.85 | 2,781 | 3 |
| West Allis, WI | $98.41 | $98.41 – $98.41 | 2,652 | 1 |
| Lafayette, CO | $129.04 | $129.04 – $129.04 | 2,641 | 1 |
| Glen Allen, VA | $75.23 | $75.23 – $75.23 | 2,531 | 1 |
| Rockville, MD | $583.94 | $583.94 – $583.94 | 2,486 | 1 |
| Jamaica, NY | $243.21 | $243.21 – $243.21 | 2,474 | 1 |
| Grenada, MS | $45.82 | $45.82 – $45.82 | 2,258 | 1 |
| Lewisville, TX | $21.90 | $2.54 – $35.60 | 2,242 | 3 |
| Philadelphia, PA | $11.67 | $0.00 – $775.93 | 2,225 | 10 |
| Orange, CA | $766.31 | $0.00 – $1,282 | 2,191 | 5 |
| Lenexa, KS | $281.92 | $281.92 – $281.92 | 2,182 | 1 |
| Tyler, TX | $880.29 | $880.29 – $880.29 | 2,112 | 1 |
| Springfield, MA | $406.75 | $386.69 – $423.16 | 2,087 | 3 |
| Rochester, NY | $329.39 | $243.00 – $457.82 | 1,913 | 3 |
| Stafford, TX | $7.89 | $7.89 – $7.89 | 1,887 | 1 |
| The Colony, TX | $35.94 | $35.94 – $35.94 | 1,876 | 1 |
| Pikeville, KY | $255.97 | $255.97 – $255.97 | 1,869 | 1 |
| St Petersburg, FL | $26.56 | $0.11 – $26.95 | 1,847 | 2 |
| Richmond, VA | $439.90 | $59.79 – $445.93 | 1,729 | 2 |
| Norristown, PA | $166.94 | $166.94 – $166.94 | 1,718 | 1 |
| Fontana, CA | $117.77 | $108.25 – $266.06 | 1,691 | 2 |
| Tacoma, WA | $91.50 | $81.12 – $281.68 | 1,623 | 2 |
| Columbia, MO | $30.68 | $30.68 – $30.68 | 1,620 | 1 |
| Waterbury, CT | $69.76 | $69.76 – $69.76 | 1,595 | 1 |
| Framingham, MA | $140.45 | $35.06 – $250.57 | 1,548 | 2 |
| Frisco, TX | $31.00 | $26.14 – $465.32 | 1,535 | 2 |
| Erie, PA | $227.79 | $227.79 – $227.79 | 1,535 | 1 |
| Buffalo, NY | $185.71 | $24.54 – $358.70 | 1,514 | 6 |
| Coppell, TX | $46.60 | $46.60 – $46.60 | 1,479 | 1 |
| Dayton, OH | $451.60 | $8.85 – $523.09 | 1,443 | 4 |
| Davie, FL | $69.55 | $69.55 – $69.55 | 1,376 | 1 |
| Gonzales, LA | $45.24 | $45.24 – $45.24 | 1,291 | 1 |
| Vancouver, WA | $118.59 | $118.59 – $118.59 | 1,272 | 1 |
| Toledo, OH | $124.75 | $0.00 – $238.51 | 1,270 | 7 |
| Lexington, KY | $598.55 | $598.55 – $598.55 | 1,265 | 1 |
| Colton, CA | $80.51 | $80.51 – $80.51 | 1,242 | 1 |
| Derby, CT | $251.73 | $251.73 – $251.73 | 1,219 | 1 |
| Oak Park, IL | $7.74 | $7.74 – $7.74 | 1,170 | 1 |
| Burbank, CA | $159.77 | $159.77 – $159.77 | 1,133 | 1 |
| Opelousas, LA | $98.79 | $98.49 – $102.47 | 1,111 | 2 |
| Helena, MT | $81.16 | $7.70 – $110.73 | 1,101 | 2 |
| Asheville, NC | $453.44 | $453.44 – $453.44 | 1,095 | 1 |
| New Brunswick, NJ | $311.06 | $53.78 – $385.56 | 1,091 | 2 |
| Moraine, OH | $125.56 | $125.56 – $125.56 | 1,085 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 81220 | CFTR gene common variants | $186.90 | 2,451,870 | 508 |
| 81243 | FMR1 gene analysis | $17.34 | 1,228,607 | 195 |
| 81161 | DMD gene duplication/deletion | $44.93 | 553,641 | 31 |
| 81200 | ASPA gene analysis | $13.64 | 480,286 | 55 |
| 81225 | CYP2C19 gene analysis | $30.77 | 435,135 | 115 |
| 81226 | CYP2D6 gene analysis | $42.17 | 433,641 | 112 |
| 81227 | CYP2C9 gene analysis | $13.84 | 416,877 | 104 |
| 81230 | CYP3A4 gene analysis | $13.12 | 390,210 | 81 |
| 81162 | BRCA1/BRCA2 full sequence | $639.56 | 231,382 | 61 |
| 81229 | Cytogenomic microarray SNP | $399.71 | 211,295 | 128 |
| 81242 | FANCC gene analysis | $12.89 | 180,433 | 72 |
| 81209 | BLM gene analysis | $15.09 | 160,111 | 60 |
| 81241 | F5 Factor V Leiden | $16.77 | 130,299 | 170 |
| 81240 | F2 prothrombin gene analysis | $15.60 | 94,205 | 144 |
| 81250 | G6PC glucose-6-phosphatase | $12.38 | 76,208 | 35 |
| 81206 | BCR/ABL1 translocation major | $46.01 | 74,525 | 79 |
| 81231 | CYP3A5 gene analysis | $16.64 | 59,184 | 83 |
| 81205 | BCKDHB gene analysis | $17.04 | 47,419 | 18 |
| 81210 | BRAF gene analysis | $32.19 | 44,458 | 25 |
| 81207 | BCR/ABL1 translocation minor | $34.44 | 41,720 | 43 |
| 81201 | APC gene full sequence | $171.79 | 39,021 | 47 |
| 81235 | EGFR gene analysis | $59.57 | 34,438 | 28 |
| 81219 | CALR gene analysis | $30.08 | 23,478 | 32 |
| 81244 | FMR1 gene characterization | $16.35 | 21,715 | 24 |
| 81211 | BRCA1/BRCA2 common variants | $790.93 | 19,033 | 20 |
| 81163 | BRCA1/BRCA2 full seq known | $136.86 | 14,168 | 5 |
| 81222 | CFTR dup/del variants | $68.86 | 13,269 | 16 |
| 81170 | ABL1 gene analysis | $74.18 | 13,088 | 6 |
| 81236 | EZH2 gene analysis | $43.74 | 13,050 | 13 |
| 81213 | BRAF gene common variants | $215.93 | 12,502 | 8 |
| 81175 | ASXL1 gene analysis | $98.65 | 11,184 | 11 |
| 81223 | CFTR full gene sequence | $376.17 | 10,979 | 30 |
| 81232 | DPYD gene analysis | $11.89 | 9,052 | 36 |
| 81249 | G6PC gene analysis | $108.64 | 8,460 | 20 |
| 81202 | APC gene known variants | $36.58 | 8,071 | 2 |
| 81224 | CFTR intron 8 poly-T analysis | $25.15 | 6,826 | 1 |
| 81238 | F9 coagulation factor IX | $88.85 | 6,714 | 20 |
| 81203 | APC gene dup/del variants | $112.77 | 6,140 | 12 |
| 81216 | BRCA2 full sequence | $9.31 | 4,286 | 7 |
| 81208 | BCR/ABL1 translocation other | $42.10 | 4,195 | 5 |
| 81245 | FLT3 gene analysis | $28.71 | 4,023 | 6 |
| 81247 | G6PD gene analysis | $12.85 | 3,807 | 10 |
| 81228 | Cytogenomic microarray copy | $147.79 | 1,796 | 9 |
| 81233 | BTK gene analysis | $15.03 | 1,612 | 6 |
| 81218 | CEBPA gene full sequence | $60.01 | 1,088 | 8 |
| 81234 | CALR gene analysis type 1 | $30.95 | 800 | 1 |
| 81212 | BRCA1/BRCA2 185delAG | $75.51 | 460 | 4 |
| 81214 | BRCA1 gene partial seq | $22.10 | 415 | 1 |
| 81176 | ASXL1 gene analysis targeted | $42.41 | 215 | 1 |
| 81165 | BRCA1 full sequence | $44.39 | 154 | 2 |
| 81167 | BRCA2 full sequence | $63.15 | 89 | 1 |
| 81215 | BRCA1 known familial variant | $139.73 | 74 | 1 |
| 81237 | EZH2 gene full sequence | $21.78 | 45 | 1 |
| 81217 | BRCA2 known familial variant | $97.91 | 41 | 1 |
| 81246 | FLT3 gene analysis ITD variants | $6.76 | 41 | 1 |
| 81164 | BRCA1/BRCA2 full seq dup/del | $0.00 | 35 | 2 |
| 81166 | BRCA1 full dup/del analysis | $32.65 | 18 | 1 |
| 81221 | CFTR known familial variants | — | — | — |
| 81239 | DMPK gene analysis | — | — | — |
| 81248 | GBA glucocerebrosidase gene | — | — | — |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.