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Moderate-Complexity Genetic Analysis

Colorado rates for HCPCS 81403

This genetic test analyzes a specific inherited gene change of moderate testing complexity. It's used when the gene involved doesn't have its own dedicated, individually named test, so a standardized level of testing is used instead based on the complexity of the analysis required. It helps confirm or rule out a specific genetic condition being considered by a doctor or genetic counselor.

Rates data updated July 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$219

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $219 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $501 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 7 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$141$100 to $151
FacilityA hospital or hospital-owned outpatient department$501$245 to $776

How much rates vary

Facilitymedian $501 · 10th to 90th $141 to $871Professionalmedian $141 · 10th to 90th $78 to $200
$100$200$500$1Kfacility $501professional $141

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
$117.49
Median
$407.38
Typical High
$851.14
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$199.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$549.54
Typical High
$933.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$77.62
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$120.23
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$269.15
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$281.84
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$263.03
Typical High
$1,513.56
Select Health
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$338.84
Typical High
$389.05
Select Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$147.91

Where Colorado sits

The same service costs 4.2 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.

Colorado· 10th of 51

$219

AK $417VT $100

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.