go back

VKORC1 Warfarin Sensitivity Gene Test

Massachusetts 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 Massachusetts, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $174 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$89.13$67.61 to $89.13
FacilityA hospital or hospital-owned outpatient department$174$129 to $251

How much rates vary

Facilitymedian $174 · 10th to 90th $89 to $282Professionalmedian $89 · 10th to 90th $50 to $219
$50$100$200$500$1K$2K$5Kfacility $174professional $89

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
$50.12
Median
$151.36
Typical High
$257.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$263.03
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$257.04
Typical High
$416.87
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$173.78
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$26.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$97.72
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$95.50
Typical High
$229.09
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$3,630.78
Typical High
$9,772.37
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$128.82
Typical High
$151.36
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$162.18
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$257.04
Typical High
$416.87
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$104.71
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$199.53

Where Massachusetts 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.

Massachusetts· 17th 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.