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VKORC1 Warfarin Sensitivity Gene Test

Pennsylvania 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 October 2026.

How much does VKORC1 Warfarin Sensitivity Gene Test cost?

$70.79

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $70.79 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $105 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$69.18$63.10 to $75.86
FacilityA hospital or hospital-owned outpatient department$105$89.13 to $257

How much rates vary

Facilitymedian $105 · 10th to 90th $71 to $447Professionalmedian $69 · 10th to 90th $50 to $132
$100$1K$10Kfacility $105professional $69

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$74.13
Typical High
$257.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$70.79
Typical High
$74.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$35.48
Typical High
$37.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.80
Median
$14.45
Typical High
$15.14
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$446.68
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$69.18
Typical High
$213.80
Cigna
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$144.54
Typical High
$263.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$93.33
Typical High
$134.90
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$114.82
Typical High
$114.82
Geisinger
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Geisinger
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$141.25
Typical High
$223.87
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$302.00
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$70.79
Typical High
$74.13
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$35.48
Typical High
$37.15
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.80
Median
$14.45
Typical High
$15.14
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$89.13
Typical High
$218.78
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$89.13
United
Setting
Facility
Modifier
None
Typical Low
$79.43
Median
$89.13
Typical High
$104.71
United
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$52.48
Typical High
$104.71

Where Pennsylvania sits

The same service costs 3.8 times more in Alaska than in Florida. 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.

Pennsylvania· 39th of 51

$70.79

AK $200FL $52.48

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.