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VKORC1 Warfarin Sensitivity Gene Test

Illinois 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 Illinois, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $138 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 5 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$74.13$70.79 to $105
FacilityA hospital or hospital-owned outpatient department$138$91.20 to $182

How much rates vary

Facilitymedian $138 · 10th to 90th $72 to $240Professionalmedian $74 · 10th to 90th $50 to $178
$50$100$200$500$1Kfacility $138professional $74

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
$72.44
Median
$138.04
Typical High
$181.97
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$72.44
Typical High
$162.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$309.03
Typical High
$1,096.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$67.61
Typical High
$67.61
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$186.21
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$109.65
Typical High
$147.91
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$186.21
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$89.13

Where Illinois 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.

Illinois· 19th 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.