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Moderate-Complexity Genetic Analysis

Connecticut 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?

$251

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $309 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 5 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$186$100 to $339
FacilityA hospital or hospital-owned outpatient department$309$219 to $407

How much rates vary

Facilitymedian $309 · 10th to 90th $186 to $513Professionalmedian $186 · 10th to 90th $100 to $417
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $309professional $186

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
$186.21
Median
$323.59
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$416.87
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$288.40
Typical High
$501.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$234.42
Typical High
$316.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$295.12
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$223.87
Typical High
$389.05
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$151.36
Typical High
$309.03

Where Connecticut sits

The same service costs 4.2 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Connecticut $251 · 4th of 51
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.