Moderate-Complexity Genetic Analysis

Delaware 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 October 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$123

Typical negotiated rate. In Delaware, October 2026.

Insurers have agreed to pay about $123 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $191 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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.

Prices by location type

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$112	$83.18 to $155
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$191	$155 to $741

How much rates vary

Facilitymedian $191 · 10th to 90th $120 to $851Professionalmedian $112 · 10th to 90th $78 to $275

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

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $407.38	Facility	None	$154.88	$154.88	$407.38
Aetna Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $158.49	Professional	None	$107.15	$154.88	$158.49
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $512.86	Facility	None	$120.23	$120.23	$512.86
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $891.25	Professional	None	$123.03	$123.03	$891.25
Highmark BCBS Setting Facility Modifier None Typical Low $186.21 Median $741.31 Typical High $891.25	Facility	None	$186.21	$741.31	$891.25
United Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $275.42	Professional	None	$77.62	$112.20	$275.42

Where Delaware sits

The same service costs 3.7 times more in Alaska than in Kentucky. 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.

Delaware· 49th of 51

$123

AK $417KY $112

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.