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Moderate-Complexity Genetic Analysis

Florida 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 Florida, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $234 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 8 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$129$100 to $151
FacilityA hospital or hospital-owned outpatient department$234$166 to $501

How much rates vary

Facilitymedian $234 · 10th to 90th $132 to $741Professionalmedian $129 · 10th to 90th $100 to $200
$10$20$50$100$200$500$1Kfacility $234professional $129

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
$131.83
Median
$223.87
Typical High
$741.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$128.82
Typical High
$177.83
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
AvMed
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$186.21
Typical High
$218.78
AvMed
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$186.21
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$151.36
Typical High
$331.13
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$67.61
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$165.96
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$81.28
Typical High
$275.42
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$186.21
Typical High
$186.21

Where Florida 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.

Florida· 48th 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.