Procedure price report · Pathology
Breast cancer 70-gene metastasis risk test by sequencing
CPT code CPT 81523the billing code this page is about
A gene expression test on stored breast tumor tissue that reads 70 target genes plus 31 reference genes by sequencing and reports an index for risk of distant spread.
Hospitals typically charge $4,260 cash for this outpatient procedure — the median across 137 hospitals that filed a usable cash price; the average of the middle 60% is $4,968. Most fall between $3,718 and $7,933 (20th–80th percentile).
- Hospitals
- 137
- States
- 24
- Filings dated
- Jun 2025 – Sep 2026
- Computed
- September 25, 2026
- Prices checked
- through September 23, 2026
Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.
What hospitals charge, from cheapest to most expensive
| 10th | 25th | Median | 75th | 90th |
|---|---|---|---|---|
| $2,614 | $3,718 | $4,260 | $6,507 | $12,932 |
The most expensive tenth of hospitals charges at least 4.9× what the cheapest tenth charges ($2,614 vs $12,932).
How the prices are spread
| From | To | Hospitals |
|---|---|---|
| $1,847 | $2,501 | 4 |
| $2,501 | $3,388 | 14 |
| $3,388 | $4,588 | 50 |
| $4,588 | $6,214 | 10 |
| $6,214 | $8,416 | 29 |
| $8,416 | $11,398 | 6 |
| $11,398 | $15,437 | 7 |
| $15,437 | $20,907 | 1 |
| $20,907 | $28,315 | 2 |
| $28,315 | $38,348 | 2 |
By state
The median cash price in each state, against the national median of $4,260.
| State | Hospitals | Median | vs national | 20th–80th |
|---|---|---|---|---|
| California CA | 22 | $6,507 | +53% | $6,507 – $6,507 |
| New Jersey NJ | 23 | $4,260 | 0% | $3,873 – $4,260 |
| New York NY | 14 | $3,873 | −9% | $3,873 – $12,932 |
| Iowa IA | 11 | $3,718 | −13% | $3,718 – $3,718 |
| Mississippi MS | 10 | $3,137 | −26% | $2,745 – $5,751 |
| Pennsylvania PA | 9 | not enough hospitals filed a usable price | ||
| Indiana IN | 7 | not enough hospitals filed a usable price | ||
| Michigan MI | 5 | not enough hospitals filed a usable price | ||
| Nebraska NE | 5 | not enough hospitals filed a usable price | ||
| Tennessee TN | 5 | not enough hospitals filed a usable price | ||
| Virginia VA | 5 | not enough hospitals filed a usable price | ||
| Connecticut CT | 4 | not enough hospitals filed a usable price | ||
| Illinois IL | 3 | not enough hospitals filed a usable price | ||
| Arkansas AR | 2 | not enough hospitals filed a usable price | ||
| Nevada NV | 2 | not enough hospitals filed a usable price | ||
| Oklahoma OK | 2 | not enough hospitals filed a usable price | ||
| Arizona AZ | 1 | not enough hospitals filed a usable price | ||
| Florida FL | 1 | not enough hospitals filed a usable price | ||
| Kentucky KY | 1 | not enough hospitals filed a usable price | ||
| Missouri MO | 1 | not enough hospitals filed a usable price | ||
| Rhode Island RI | 1 | not enough hospitals filed a usable price | ||
| South Carolina SC | 1 | not enough hospitals filed a usable price | ||
| Texas TX | 1 | not enough hospitals filed a usable price | ||
| Washington WA | 1 | not enough hospitals filed a usable price | ||
Hospitals like yours
The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $4,260.
| Segment | Hospitals | Median | 20th–80th |
|---|---|---|---|
| Hospital type | |||
| Acute care | 128 | $4,260 | $3,718 – $8,296 |
| Critical access | 9 | fewer than 20 hospitals | |
| Ownership | |||
| For-profit | 8 | fewer than 20 hospitals | |
| Government | 11 | fewer than 20 hospitals | |
| Non-profit | 118 | $4,260 | $3,718 – $7,933 |
| System affiliation | |||
| Part of a system | 130 | $4,260 | $3,718 – $7,933 |
| Independent | 7 | fewer than 20 hospitals | |
Cash price vs list price
At the typical hospital, asking for the cash price cuts the list price by about 44%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.
How complete is this
137 of the 3,956 hospitals with a price file in our corpus (3%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.
| Usable cash price — counted | 137 |
|---|---|
| Cash price carrying a plausibility flag — shown on the compare tool, excluded here | 9 |
| A number the filing itself marks as not a price (a placeholder, a ratio) — excluded | 1 |
| An estimate rather than a filed cash price — excluded | 0 |
| A list price only, no cash figure — excluded | 7 |
| Hospitals that filed this code | 154 |
Sections not shown for this setting
- Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
- Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.
We last checked these hospitals’ price files for changes between September 5, 2026 and September 23, 2026; the figures were computed September 25, 2026 from filings loaded through September 23, 2026. The percentiles and averages use only the “counted” row.
Related procedures
Part of the Pathology family.
Hospitals file this code under descriptions such as ONC BRST MRNA 70 CNT 31 GENE
.
Method
- Source
- The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
- What counts
- One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
- Statistics
- Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
- Names
- Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.
The full rules — sources, statistics, thresholds, limitations — are on the methodology page.
Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.
Cite: HospitalRates.com, “Breast cancer 70-gene metastasis risk test by sequencing (CPT 81523) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-81523-breast-cancer-70-gene-metastasis-risk-test-by-sequencing