go back

VKORC1 Warfarin Sensitivity Gene Test

North Carolina 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?

$74.13

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $79.43 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$70.79$69.18 to $100
FacilityA hospital or hospital-owned outpatient department$79.43$70.79 to $148

How much rates vary

Facilitymedian $79 · 10th to 90th $60 to $295Professionalmedian $71 · 10th to 90th $44 to $117
$50$100$200facility $79professional $71

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
$54.95
Median
$77.62
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$70.79
Typical High
$117.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$269.15
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$100.00
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$194.98
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$41.69
Typical High
$117.49
Medcost
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$138.04
Medcost
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$104.71
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$93.33
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$660.69

Where North Carolina 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.

North Carolina· 35th of 51

$74.13

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.