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VKORC1 Warfarin Sensitivity Gene Test

Maine 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 Maine, 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 $141 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 6 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$70.79 to $89.13
FacilityA hospital or hospital-owned outpatient department$141$89.13 to $398

How much rates vary

Facilitymedian $141 · 10th to 90th $89 to $417Professionalmedian $89 · 10th to 90th $52 to $98
$50$100$200$500facility $141professional $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
$89.13
Median
$89.13
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$70.79
Typical High
$89.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$416.87
Typical High
$457.09
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$52.48
Typical High
$58.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$87.10
Typical High
$89.13
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$104.71
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$398.11
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$89.13
Typical High
$97.72
United
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$134.90

Where Maine 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.

Maine· 18th 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.