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VKORC1 Warfarin Sensitivity Gene Test

New Mexico 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?

$105

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $331 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$72.44$66.07 to $105
FacilityA hospital or hospital-owned outpatient department$331$155 to $646

How much rates vary

Facilitymedian $331 · 10th to 90th $79 to $891Professionalmedian $72 · 10th to 90th $37 to $589
$100$1K$10K$100Kfacility $331professional $72

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
$131.83
Median
$263.03
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$588.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$562.34
Typical High
$954.99
BCBS
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$72.44
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$79.43
Typical High
$100.00
Providence
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$112.20
Typical High
$173.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$100.00
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$79.43
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$37.15
Typical High
$70.79

Where New Mexico 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 Mexico· 9th of 51

$105

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.