FMR1 gene analysis for fragile X syndrome

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB=CSHB FMR1 (FRAGILE X) GENE ANALYSIS

Payers reporting CPT 81243

Payer pricing summary

Low

$33

Average

$207

Median

$176

High

$549

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +33 other terms	801	$57	$66	$46	69%	2–20	$1 – $690
2	Cigna fee schedule · outpatient · +22 other terms	512	$111	$116	$90	78%	1–10	$5 – $787
3	Aetna fee schedule · outpatient · +29 other terms	735	$70	$133	$322	242%	—	$0 – $8.4k
4	Humana fee schedule · outpatient · +25 other terms	527	$58	$162	$588	363%	—	$1 – $7.0k
5	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	486	$80	$123	$132	107%	—	$0 – $1.9k
6	WellCare fee schedule · outpatient · +16 other terms	328	$59	$59	$25	42%	—	$9 – $438
7	Molina fee schedule · outpatient · +29 other terms	286	$63	$68	$29	43%	—	$1 – $308
8	Anthem fee schedule · outpatient · +23 other terms	211	$68	$88	$84	95%	—	$10 – $428
9	Devoted fee schedule · outpatient · +13 other terms	195	$57	$58	$2	3%	—	$56 – $66
10	Oscar fee schedule · outpatient · +17 other terms	165	$110	$122	$41	33%	—	$56 – $175
11	Cigna Healthspring fee schedule · outpatient · +7 other terms	131	$59	$58	$5	9%	—	$34 – $95
12	Kaiser fee schedule · outpatient · +18 other terms	120	$58	$72	$45	63%	—	$5 – $396
13	Ambetter facility · fee schedule · outpatient · +16 other terms	112	$103	$103	$24	24%	—	$31 – $145
14	Aetna Better Health fee schedule · outpatient · +19 other terms	89	$52	$59	$25	42%	—	$30 – $194
15	Caresource fee schedule · outpatient · +14 other terms	77	$58	$67	$54	81%	—	$1 – $392
16	MultiPlan fee schedule · outpatient · +16 other terms	77	$99	$152	$152	101%	—	$25 – $753
17	Highmark facility · fee schedule · outpatient · +14 other terms	73	$99	$209	$201	96%	—	$48 – $782
18	Optum facility · fee schedule · outpatient · +19 other terms	64	$57	$56	$5	8%	—	$46 – $68
19	First Health fee schedule · outpatient · +16 other terms	62	$63	$87	$77	88%	—	$48 – $502
20	Medicaid facility · fee schedule · outpatient · +12 other terms	55	$56	$58	$26	45%	—	$24 – $312
21	Superior Healthplan fee schedule · outpatient · +6 other terms	55	$60	$379	$311	82%	—	$48 – $980
22	Tricare facility · fee schedule · outpatient · +15 other terms	54	$57	$942	$6.1k	651%	—	$45 – $50k
23	Medicare facility · fee schedule · outpatient · +12 other terms	50	$56	$71	$70	98%	—	$56 – $424
24	Clover fee schedule · outpatient · +8 other terms	48	$59	$58	$1	2%	—	$57 – $60
25	Medica facility · fee schedule · outpatient · +15 other terms	48	$57	$61	$26	42%	—	$19 – $242

Page 1 of 3 · 68 payers