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Moderate-Complexity Genetic Analysis

Washington, DC 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?

$138

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $490 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$138$138 to $145
FacilityA hospital or hospital-owned outpatient department$490$138 to $759

How much rates vary

Facilitymedian $490 · 10th to 90th $138 to $832Professionalmedian $138 · 10th to 90th $115 to $355
$100$200$500$1Kfacility $490professional $138

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
$138.04
Median
$489.78
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$144.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$354.81
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$316.23
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$234.42
Typical High
$831.76
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$323.59
Typical High
$380.19
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$223.87
Typical High
$1,949.84
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$954.99

Where Washington, DC 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.

Washington, DC· 47th of 51

$138

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.