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VKORC1 Warfarin Sensitivity Gene Test

New Jersey 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?

$70.79

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $70.79 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $257 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$58.88$50.12 to $72.44
FacilityA hospital or hospital-owned outpatient department$257$115 to $525

How much rates vary

Facilitymedian $257 · 10th to 90th $89 to $9,333Professionalmedian $59 · 10th to 90th $50 to $102
$50$200$1K$5K$20Kfacility $257professional $59

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
$112.20
Median
$281.84
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$194.98
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$93.33
Typical High
$194.98
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$93.33
Typical High
$165.96
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$89.13
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$89.13
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$93.33

Where New Jersey 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.

New Jersey· 41st of 51

$70.79

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.