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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 July 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$155

Typical negotiated rate. In Delaware, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $123 from a physician practice, and about $214 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$123$100 to $155
FacilityA hospital or hospital-owned outpatient department$214$155 to $794

How much rates vary

Facilitymedian $214 · 10th to 90th $49 to $1,660Professionalmedian $123 · 10th to 90th $100 to $550
$50$100$200$500$1Kfacility $214professional $123

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
$48.98
Median
$213.80
Typical High
$1,659.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$851.14
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$275.42

Where Delaware 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.

Delaware· 40th of 51

$155

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.