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VKORC1 Warfarin Sensitivity Gene Test

Montana 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?

$120

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $132 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$110$102 to $269
FacilityA hospital or hospital-owned outpatient department$132$110 to $174

How much rates vary

Facilitymedian $132 · 10th to 90th $89 to $269Professionalmedian $110 · 10th to 90th $37 to $589
$50$100$200$500facility $132professional $110

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
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$151.36
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$269.15
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$269.15
Providence
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$173.78
Typical High
$501.19
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$37.15
Typical High
$89.13

Where Montana 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.

Montana· 5th of 51

$120

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.