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VKORC1 Warfarin Sensitivity Gene Test

Rhode Island 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?

$50.12

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $105 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 4 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$50.12$50.12 to $66.07
FacilityA hospital or hospital-owned outpatient department$105$102 to $132

How much rates vary

Facilitymedian $105 · 10th to 90th $89 to $513Professionalmedian $50 · 10th to 90th $50 to $89
$50$100$200$500facility $105professional $50

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
BCBS
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$102.33
Typical High
$112.20
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$125.89

Where Rhode Island 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.

Rhode Island· 50th of 51

$50.12

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.