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Moderate-Complexity Genetic Analysis

Georgia 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?

$174

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $240 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 7 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$162$112 to $209
FacilityA hospital or hospital-owned outpatient department$240$166 to $302

How much rates vary

Facilitymedian $240 · 10th to 90th $129 to $407Professionalmedian $162 · 10th to 90th $78 to $380
$100$200$500$1Kfacility $240professional $162

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
$128.82
Median
$302.00
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$380.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$213.80
Typical High
$257.04
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$74.13
Typical High
$371.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$239.88
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$302.00
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$190.55
Typical High
$549.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$239.88
Typical High
$1,445.44
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$229.09
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$186.21
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$245.47

Where Georgia 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.

Georgia· 33rd of 51

$174

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.