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VKORC1 Warfarin Sensitivity Gene Test

Ohio 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 Ohio, 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 $120 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 8 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$46.77 to $83.18
FacilityA hospital or hospital-owned outpatient department$120$89.13 to $195

How much rates vary

Facilitymedian $120 · 10th to 90th $71 to $214Professionalmedian $71 · 10th to 90th $35 to $145
$50$100$200facility $120professional $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
$70.79
Median
$158.49
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$199.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$93.33
Typical High
$162.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$45.71
Typical High
$114.82
CareSource
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
CareSource
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$114.82
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$47.86
Typical High
$199.53
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$117.49
Typical High
$363.08
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$47.86
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$95.50
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$123.03

Where Ohio 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.

Ohio· 38th 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.