go back

VKORC1 Warfarin Sensitivity Gene Test

Iowa rates for HCPCS 81355

A genetic test that checks for the common changes in the VKORC1 gene, which affects how strongly a person responds to the blood thinner warfarin. People carrying certain versions need a lower or a higher dose to reach a safe level of blood thinning. A blood or saliva sample is used.

Rates data updated July 2026.

How much does VKORC1 Warfarin Sensitivity Gene Test cost?

$89.13

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $75.86 from a physician practice, and about $135 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$75.86$67.61 to $170
FacilityA hospital or hospital-owned outpatient department$135$89.13 to $224

How much rates vary

Facilitymedian $135 · 10th to 90th $68 to $257Professionalmedian $76 · 10th to 90th $52 to $589
$100$200$500facility $135professional $76

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$181.97
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$213.80
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$154.88
Typical High
$234.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$104.71
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$104.71
Typical High
$346.74
Midlands
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$117.49
Typical High
$117.49
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$95.50
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$223.87
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Iowa sits

The same service costs 4.0 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Iowa· 15th of 51

$89.13

AK $200VT $50.12

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.