{"procedure":{"code_type":"CPT","code":"81243","lay_name":"Fragile X gene test to detect abnormal repeats","blurb":"Laboratory analysis of the FMR1 gene to see whether an abnormal expanded repeat region is present. Covers one test on one sample; sizing of the repeat is billed separately.","slug":"cpt-81243-fragile-x-gene-test-to-detect-abnormal-repeats","description":"HC Fragile X Syndrome Dna W/Reflex","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"234","label":"Pathology","surgery_flag":"n/a"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T10:46:50.712029Z","filing_date_min":"2024-01-01","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:22:45.003818Z","checked_through":"2026-09-25T10:46:52.415798Z","n_priced_setters":3956,"n_filed":2295,"n_usable":2097,"n_not_usable":1,"n_labelled":116,"n_no_cash":80,"n_estimated":1,"n_states":50,"cash_p10":62.79,"cash_p20":96.5,"cash_p25":118.03,"cash_p50":233.7,"cash_p75":410.8,"cash_p80":458.81,"cash_p90":651.0,"cash_mean_trimmed":243.55,"gross_p50":389.5,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":8,"p20":null,"p50":null,"p80":null},{"state":"AL","n":18,"p20":70.95,"p50":190.0,"p80":1386.0},{"state":"AR","n":16,"p20":129.3,"p50":190.45,"p80":238.55},{"state":"AZ","n":25,"p20":65.6,"p50":162.15,"p80":480.0},{"state":"CA","n":73,"p20":91.0,"p50":130.48,"p80":244.4},{"state":"CO","n":48,"p20":152.25,"p50":198.69,"p80":440.54},{"state":"CT","n":13,"p20":168.85,"p50":201.92,"p80":350.4},{"state":"DE","n":6,"p20":null,"p50":null,"p80":null},{"state":"FL","n":91,"p20":91.0,"p50":171.12,"p80":296.57},{"state":"GA","n":67,"p20":241.5,"p50":396.0,"p80":747.9},{"state":"HI","n":8,"p20":null,"p50":null,"p80":null},{"state":"IA","n":37,"p20":127.86,"p50":143.72,"p80":399.75},{"state":"ID","n":17,"p20":118.75,"p50":157.0,"p80":243.75},{"state":"IL","n":104,"p20":172.85,"p50":355.0,"p80":675.0},{"state":"IN","n":76,"p20":86.68,"p50":191.83,"p80":350.27},{"state":"KS","n":26,"p20":222.18,"p50":296.8,"p80":654.36},{"state":"KY","n":44,"p20":171.12,"p50":288.0,"p80":861.54},{"state":"LA","n":34,"p20":78.68,"p50":122.31,"p80":401.5},{"state":"MA","n":40,"p20":96.87,"p50":190.0,"p80":391.0},{"state":"MD","n":29,"p20":111.8,"p50":230.94,"p80":809.62},{"state":"ME","n":17,"p20":105.04,"p50":176.48,"p80":416.8},{"state":"MI","n":70,"p20":73.19,"p50":158.95,"p80":252.0},{"state":"MN","n":67,"p20":83.41,"p50":262.16,"p80":440.0},{"state":"MO","n":51,"p20":135.0,"p50":253.5,"p80":448.5},{"state":"MS","n":25,"p20":60.63,"p50":96.06,"p80":206.88},{"state":"MT","n":9,"p20":null,"p50":null,"p80":null},{"state":"NC","n":66,"p20":53.76,"p50":147.6,"p80":318.73},{"state":"ND","n":21,"p20":99.25,"p50":139.2,"p80":324.75},{"state":"NE","n":15,"p20":63.0,"p50":320.0,"p80":582.6},{"state":"NH","n":19,"p20":85.5,"p50":267.3,"p80":594.96},{"state":"NJ","n":51,"p20":62.74,"p50":65.6,"p80":164.85},{"state":"NM","n":14,"p20":129.5,"p50":273.6,"p80":578.9},{"state":"NV","n":11,"p20":48.0,"p50":172.0,"p80":245.0},{"state":"NY","n":102,"p20":68.45,"p50":140.07,"p80":391.3},{"state":"OH","n":110,"p20":245.0,"p50":273.2,"p80":438.75},{"state":"OK","n":41,"p20":133.44,"p50":235.0,"p80":306.24},{"state":"OR","n":28,"p20":99.2,"p50":189.8,"p80":304.5},{"state":"PA","n":107,"p20":65.6,"p50":241.15,"p80":670.0},{"state":"RI","n":6,"p20":null,"p50":null,"p80":null},{"state":"SC","n":33,"p20":286.2,"p50":430.95,"p80":797.33},{"state":"SD","n":10,"p20":139.2,"p50":139.2,"p80":568.0},{"state":"TN","n":42,"p20":157.8,"p50":168.3,"p80":239.62},{"state":"TX","n":141,"p20":95.0,"p50":327.0,"p80":648.94},{"state":"UT","n":33,"p20":149.25,"p50":181.24,"p80":213.22},{"state":"VA","n":54,"p20":171.5,"p50":248.37,"p80":405.0},{"state":"VT","n":12,"p20":239.2,"p50":500.22,"p80":839.0},{"state":"WA","n":45,"p20":62.8,"p50":212.8,"p80":456.4},{"state":"WI","n":83,"p20":237.6,"p50":407.57,"p80":460.2},{"state":"WV","n":23,"p20":75.0,"p50":75.0,"p80":536.2},{"state":"WY","n":11,"p20":123.67,"p50":341.0,"p80":443.2}],"by_segment":{"hospital_type":[{"key":"acute","n":1609,"p20":86.68,"p50":218.53,"p80":440.54},{"key":"childrens","n":46,"p20":149.25,"p50":258.75,"p80":655.26},{"key":"critical_access","n":433,"p20":121.3,"p50":267.3,"p80":489.51}],"ownership":[{"key":"for_profit","n":236,"p20":97.59,"p50":270.0,"p80":572.26},{"key":"government","n":299,"p20":100.0,"p50":230.69,"p80":451.8},{"key":"nonprofit","n":1553,"p20":95.0,"p50":222.0,"p80":456.18}],"affiliation":[{"key":"affiliated","n":1788,"p20":95.0,"p50":233.7,"p80":459.7},{"key":"independent","n":309,"p20":101.6,"p50":230.69,"p80":439.09}]},"histogram":[{"lo":53.05,"hi":70.1,"n":153},{"lo":70.1,"hi":92.64,"n":139},{"lo":92.64,"hi":122.42,"n":152},{"lo":122.42,"hi":161.78,"n":184},{"lo":161.78,"hi":213.79,"n":248},{"lo":213.79,"hi":282.51,"n":285},{"lo":282.51,"hi":373.33,"n":236},{"lo":373.33,"hi":493.35,"n":241},{"lo":493.35,"hi":651.95,"n":146},{"lo":651.95,"hi":861.54,"n":105}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T10:46:50.712029Z","filing_date_min":"2024-01-01","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:23:05.982663Z","checked_through":"2026-09-25T10:46:52.415798Z","n_priced_setters":3956,"n_filed":1657,"n_usable":1501,"n_not_usable":0,"n_labelled":90,"n_no_cash":66,"n_estimated":0,"n_states":50,"cash_p10":71.25,"cash_p20":115.5,"cash_p25":130.48,"cash_p50":237.6,"cash_p75":427.8,"cash_p80":460.2,"cash_p90":649.5,"cash_mean_trimmed":255.86,"gross_p50":394.0,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":1,"p20":null,"p50":null,"p80":null},{"state":"AL","n":17,"p20":94.2,"p50":190.0,"p80":1386.0},{"state":"AR","n":6,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":23,"p20":69.91,"p50":199.35,"p80":480.0},{"state":"CA","n":64,"p20":89.88,"p50":130.48,"p80":244.4},{"state":"CO","n":37,"p20":152.25,"p50":189.38,"p80":440.54},{"state":"CT","n":9,"p20":null,"p50":null,"p80":null},{"state":"DE","n":5,"p20":null,"p50":null,"p80":null},{"state":"FL","n":48,"p20":62.4,"p50":185.0,"p80":325.0},{"state":"GA","n":55,"p20":231.0,"p50":456.18,"p80":747.9},{"state":"HI","n":5,"p20":null,"p50":null,"p80":null},{"state":"IA","n":23,"p20":127.86,"p50":132.0,"p80":399.75},{"state":"ID","n":12,"p20":118.75,"p50":154.8,"p80":189.8},{"state":"IL","n":82,"p20":192.0,"p50":427.8,"p80":735.84},{"state":"IN","n":49,"p20":133.1,"p50":206.5,"p80":537.55},{"state":"KS","n":11,"p20":222.18,"p50":296.8,"p80":541.79},{"state":"KY","n":26,"p20":114.76,"p50":194.4,"p80":367.16},{"state":"LA","n":22,"p20":73.06,"p50":99.64,"p80":249.69},{"state":"MA","n":35,"p20":78.4,"p50":190.0,"p80":386.0},{"state":"MD","n":21,"p20":111.8,"p50":209.35,"p80":307.38},{"state":"ME","n":16,"p20":105.04,"p50":119.51,"p80":416.8},{"state":"MI","n":54,"p20":73.19,"p50":212.5,"p80":285.75},{"state":"MN","n":55,"p20":68.85,"p50":139.2,"p80":440.0},{"state":"MO","n":26,"p20":127.6,"p50":192.0,"p80":331.5},{"state":"MS","n":15,"p20":96.06,"p50":206.88,"p80":398.09},{"state":"MT","n":4,"p20":null,"p50":null,"p80":null},{"state":"NC","n":35,"p20":53.76,"p50":235.17,"p80":318.73},{"state":"ND","n":18,"p20":99.25,"p50":120.0,"p80":293.8},{"state":"NE","n":2,"p20":null,"p50":null,"p80":null},{"state":"NH","n":13,"p20":85.5,"p50":267.3,"p80":594.96},{"state":"NJ","n":20,"p20":65.6,"p50":66.0,"p80":346.8},{"state":"NM","n":11,"p20":129.5,"p50":325.44,"p80":578.9},{"state":"NV","n":8,"p20":null,"p50":null,"p80":null},{"state":"NY","n":45,"p20":68.45,"p50":167.21,"p80":391.3},{"state":"OH","n":104,"p20":245.0,"p50":273.2,"p80":438.75},{"state":"OK","n":33,"p20":133.44,"p50":229.2,"p80":303.4},{"state":"OR","n":13,"p20":173.55,"p50":189.8,"p80":339.63},{"state":"PA","n":97,"p20":153.0,"p50":315.0,"p80":670.0},{"state":"RI","n":2,"p20":null,"p50":null,"p80":null},{"state":"SC","n":29,"p20":296.5,"p50":430.95,"p80":797.33},{"state":"SD","n":7,"p20":null,"p50":null,"p80":null},{"state":"TN","n":39,"p20":157.8,"p50":168.3,"p80":234.12},{"state":"TX","n":113,"p20":95.0,"p50":327.0,"p80":648.94},{"state":"UT","n":26,"p20":181.24,"p50":181.24,"p80":213.22},{"state":"VA","n":39,"p20":157.8,"p50":230.69,"p80":376.33},{"state":"VT","n":8,"p20":null,"p50":null,"p80":null},{"state":"WA","n":36,"p20":78.4,"p50":201.48,"p80":456.4},{"state":"WI","n":69,"p20":237.6,"p50":323.95,"p80":460.2},{"state":"WV","n":6,"p20":null,"p50":null,"p80":null},{"state":"WY","n":7,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":1187,"p20":105.0,"p50":235.0,"p80":456.18},{"key":"childrens","n":37,"p20":149.25,"p50":361.2,"p80":655.26},{"key":"critical_access","n":268,"p20":127.86,"p50":262.0,"p80":487.5}],"ownership":[{"key":"for_profit","n":133,"p20":86.6,"p50":250.0,"p80":572.26},{"key":"government","n":190,"p20":115.6,"p50":234.45,"p80":443.2},{"key":"nonprofit","n":1169,"p20":117.74,"p50":237.6,"p80":460.2}],"affiliation":[{"key":"affiliated","n":1312,"p20":117.0,"p50":239.4,"p80":466.8},{"key":"independent","n":189,"p20":105.0,"p50":224.0,"p80":411.6}]},"histogram":[{"lo":54.8,"hi":71.63,"n":85},{"lo":71.63,"hi":93.62,"n":72},{"lo":93.62,"hi":122.36,"n":102},{"lo":122.36,"hi":159.93,"n":137},{"lo":159.93,"hi":209.03,"n":180},{"lo":209.03,"hi":273.21,"n":223},{"lo":273.21,"hi":357.09,"n":175},{"lo":357.09,"hi":466.73,"n":170},{"lo":466.73,"hi":610.03,"n":104},{"lo":610.03,"hi":797.33,"n":111}],"previous":null}},"related":[{"code_type":"CPT","code":"88305","lay_name":"Tissue exam under microscope, moderate complexity","slug":"cpt-88305-tissue-exam-under-microscope-moderate-complexity"},{"code_type":"CPT","code":"88312","lay_name":"Special stain for germs such as bacteria or fungus","slug":"cpt-88312-special-stain-for-germs-such-as-bacteria-or-fungus"},{"code_type":"CPT","code":"88342","lay_name":"Special tissue stain for one marker, first stain","slug":"cpt-88342-special-tissue-stain-for-one-marker-first-stain"},{"code_type":"CPT","code":"88304","lay_name":"Tissue exam under microscope, low complexity","slug":"cpt-88304-tissue-exam-under-microscope-low-complexity"},{"code_type":"CPT","code":"88313","lay_name":"Special tissue stain for cell structures","slug":"cpt-88313-special-tissue-stain-for-cell-structures"},{"code_type":"CPT","code":"88307","lay_name":"Tissue exam under microscope, high complexity","slug":"cpt-88307-tissue-exam-under-microscope-high-complexity"},{"code_type":"CPT","code":"81241","lay_name":"Factor V Leiden blood clotting gene mutation test","slug":"cpt-81241-factor-v-leiden-blood-clotting-gene-mutation-test"},{"code_type":"CPT","code":"88302","lay_name":"Tissue exam under microscope, simplest level","slug":"cpt-88302-tissue-exam-under-microscope-simplest-level"},{"code_type":"CPT","code":"88184","lay_name":"Flow cytometry cell marker testing, first marker","slug":"cpt-88184-flow-cytometry-cell-marker-testing-first-marker"},{"code_type":"CPT","code":"88341","lay_name":"Special tissue stain for one more marker","slug":"cpt-88341-special-tissue-stain-for-one-more-marker"},{"code_type":"CPT","code":"88300","lay_name":"Tissue exam by eye only, no microscope","slug":"cpt-88300-tissue-exam-by-eye-only-no-microscope"},{"code_type":"CPT","code":"81240","lay_name":"Prothrombin blood clotting gene mutation test","slug":"cpt-81240-prothrombin-blood-clotting-gene-mutation-test"}]}