Billing Information
Empowering patients, affordably
We understand that cost is an important factor when considering genetic testing. We strive to provide price transparency as well as access to billing options and programs that help make testing more affordable for you and your family.
Our commitment to transparent pricing
When testing is ordered, we will determine your personalized cost estimate based on the insurance information provided by your clinician. Our Patient and Family Relations team reviews the submitted data, and if we estimate your out-of-pocket expense is exceeding $100, we will reach out to you to discuss all possible payment options.
Our billing options
We offer multiple ways for you to pay for testing. If you have questions about any of the options below, please contact our Patient and Family Relations team for more information.
Commercial Insurance
Insurance billing is available for our Genomic Unity®, IriSight® and OncoAlly® tests. If you have US-based insurance, our Patient and Family Relations team will collaborate with your clinician and insurance provider to ensure that the ordered testing meets the insurance provider’s specific genetic testing criteria. When testing is covered, you may still have an out-of-pocket responsibility (i.e. deductible, coinsurance, or copay). In most cases, if testing has already been ordered, our Patient and Family Relations team will be in touch to review the estimate of your responsibility and available payment options. However, if you have questions at any time, please contact us.
Medicaid
Due to plan restrictions Genomic Unity® Whole Genome Analysis, Genomic Unity® Exome Plus Analysis, Genomic Unity® Exome Analysis or IriSight® tests will not be accepted as first-line testing for Medicaid or Managed Medicaid from the following states:
- Alabama, Alaska, Arkansas, Colorado, Delaware, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, Rhode Island, South Carolina, North Carolina, Texas, Vermont.
For the above Medicaid’s we accept Genomic Unity® Constitutional Genome-Wide Copy Number Variant Analysis, Genomic Unity® Targeted Analyses and OncoAlly® with discounted reflex pricing to more comprehensive testing (Genomic Unity® Whole Genome Analysis, Genomic Unity® Exome Plus Analysis, Genomic Unity® Exome Analysis), if applicable.
Medicare
While many of our tests are currently not billable under Medicare, we do our best to work with Medicare Advantage and Managed Medicare plans. If you are enrolled in Medicare Part B, please contact our Patient and Family Relations team regarding our pricing details.
Self-pay
If you do not have US-based insurance, or your insurance plan doesn’t cover the testing ordered, we offer self-pay pricing.
Our Patient Assistance Program
We realize that you and your family face a multitude of expenses, and that fitting the cost of genetic testing into your budget may be difficult. Rooted in our goal to make whole-genome based testing accessible to all patients, regardless of their financial situation, we’ve designed our Patient Assistance Program to provide assistance when testing would otherwise be financially out of reach.
If you:
- Have commercial insurance
- Have testing services deemed medically necessary by your insurance provider
- Have a household income that falls within our guidelines outlined in the table below
You may be eligible for a reduction in the amount owed for the patient responsibility reflected on the explanation of benefits (EOB) sent in the mail by your insurance provider.
The price will be the lowest of the estimated or actual out-of-pocket amount compared to the numbers below:
Genomic Unity® tests
| Percentage of household income relative to federal poverty guidelines* | Panel | CNV | Singleton WES/WESP/WGS | Duo WES/WESP/WGS | Trio WES/WESP/WGS | Add’l Comparator WES/WESP/WGS |
| 0-100% | $500 | $600 | $800 | $800 | $800 | $600 |
| 101%-200% | $550 | $650 | $1,000 | $1,000 | $1,000 | $600 |
| 201%-300% | $650 | $700 | $1,200 | $1,200 | $1,200 | $600 |
| 301%-400% | $750 | $800 | $1,600 | $1,600 | $1,600 | $600 |
| >400% (catalog) | $850 | $900 | $2,100 | $2,100 | $2,100 | $800 |
IriSight® tests
| Percentage of household income relative to federal poverty guidelines* | CNV | WGS |
| 0-100% | $500 | $1,000 |
| 101%-200% | $550 | $1,500 |
| 201%-300% | $650 | $2,000 |
| 301%-400% | $750 | $2,400 |
| >400% (catalog) | $850 | $2,800 |
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We are in-network with many national and regional healthcare plans, and our coverage area is continually expanding. You can view the plans we are currently participating with here.
Please note that being in-network with your insurance provider does NOT mean that your out-of-pocket responsibility will be $0. You may still have some out-of-pocket responsibility (i.e. deductible, coinsurance, or copay).
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Most healthcare plans require the clinician or Variantyx to submit a preauthorization, in order for your testing to be covered by the plan. If preauthorization for testing is denied by your plan, self-pay pricing is available.
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No. You may receive an explanation of benefits (EOB) from your insurance provider in the mail, but it is NOT a bill. It is merely a notification that your claim has been processed. In most cases, Variantyx has received the same correspondence. Depending on the outcome of the processing, we may initiate an appeal on your behalf to facilitate coverage of your testing. There is a possibility you may receive additional correspondence from Variantyx and/or your insurance provider during this process. Once your claim has reached a final processed status, if there is an outstanding patient responsibility, you will receive a bill from Variantyx with instructions on how to remit payment.
Please note that Variantyx does NOT Balance Bill their patients. This means that Variantyx does not bill in excess of what was allowed by your healthcare plan, regardless of your healthcare plan’s participation status.
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In some cases, when Variantyx is out-of-network with your healthcare plan, both the explanation of benefits (EOB) and the payment for your testing services may be directed to you. Variantyx may not be notified of how the claim for your testing services was processed, and therefore you may receive a full bill for your services. To resolve that bill, please choose one of the following two options:
1. Endorse and mail the check, along with the corresponding explanation of benefits (EOB), to Variantyx. Please endorse the check by writing “Pay to the Order of Variantyx” on the back of the check and placing your signature underneath.
Please mail to:
Variantyx, Inc.
Attn: Billing Department
1671 Worcester Road, Suite 300
Framingham, MA 01701
2. Cash the check and remit payment for the same amount to Variantyx via check, credit card or money order. Credit card payment can be made by phone by calling 617-209-2090 and selecting Option 1. Please send the corresponding explanation of benefits (EOB) separately if paying by phone.
Please note that if there is an additional patient responsibility allocated on your explanation of benefits (EOB) (such as deductible, coinsurance, copay), you are responsible for those amounts in addition to the payment provided to you by the insurance provider and will be billed accordingly.
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Our self-pay pricing was implemented for our uninsured patients, however, if your plan deductible makes your testing cost prohibitive, you can access self-pay pricing.
Please note that if you choose to use self-pay pricing, the amount paid will not contribute toward your insurance plan’s annual deductible and you cannot submit a claim to your insurance for this amount. Please consider that if you are anticipating additional health care expenditures this calendar year, utilizing insurance for your testing may be less cost prohibitive overall.
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Payment may be made by check, credit card or money order.
Please mail checks and money orders to:
Variantyx, Inc.
Attn: Billing Department
1671 Worcester Road, Suite 300
Framingham, MA 01701
Credit card payment can be made by phone by calling 617-209-2090 and selecting Option 1.
FSA and HSA cards are accepted.
Payments can also be made directly in our Patient Portal.
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