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VKORC1 Warfarin Sensitivity Gene Test

New York 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?

$87.10

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $151 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 9 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$43.65 to $100
FacilityA hospital or hospital-owned outpatient department$151$93.33 to $204

How much rates vary

Facilitymedian $151 · 10th to 90th $74 to $240Professionalmedian $71 · 10th to 90th $35 to $158
$20$50$100$200$500$1K$2Kfacility $151professional $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
$74.13
Median
$151.36
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$74.13
Typical High
$158.49
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$229.09
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$128.82
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$89.13
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$190.55
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$123.03
Typical High
$426.58
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$194.98
Typical High
$331.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$165.96
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$158.49
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$165.96
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$89.13
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$89.13
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$79.43
Typical High
$213.80
Univera
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$81.28
Typical High
$93.33
Univera
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$208.93

Where New York 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 York· 25th of 51

$87.10

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.