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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 October 2026.

How much does VKORC1 Warfarin Sensitivity Gene Test cost?

$79.43

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $166 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$72.44$52.48 to $105
FacilityA hospital or hospital-owned outpatient department$166$105 to $309

How much rates vary

Facilitymedian $166 · 10th to 90th $72 to $562Professionalmedian $72 · 10th to 90th $37 to $158
$5$20$100$500facility $166professional $72

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$72.44
Median
$138.04
Typical High
$269.15
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$36.31
Median
$69.18
Typical High
$134.90
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$14.45
Median
$27.54
Typical High
$53.70
Aetna
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$72.44
Typical High
$75.86
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$35.48
Median
$36.31
Typical High
$39.81
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$14.13
Median
$14.45
Typical High
$15.85
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$151.36
Typical High
$1,122.02
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$67.61
Typical High
$67.61
Cigna
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$181.97
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$120.23
Typical High
$147.91
Hally Health
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$138.04
Typical High
$288.40
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$104.71
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$52.48
Typical High
$89.13

Where Illinois sits

The same service costs 3.8 times more in Alaska than in Florida. 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· 32nd of 51

$79.43

AK $200FL $52.48

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.