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Moderate-Complexity Genetic Analysis

Iowa 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?

$200

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $331 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$186$112 to $355
FacilityA hospital or hospital-owned outpatient department$331$224 to $417

How much rates vary

Facilitymedian $331 · 10th to 90th $186 to $490Professionalmedian $186 · 10th to 90th $112 to $661
$100$200$500$1Kfacility $331professional $186

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$389.05
Typical High
$524.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$144.54
Typical High
$223.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$354.81
Typical High
$446.68
Hally Health
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$309.03
Typical High
$660.69
Medica
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$331.13
Typical High
$426.58
Medica
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$223.87
Typical High
$933.25
Midlands
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$229.09
Typical High
$245.47
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$199.53
Typical High
$398.11
United
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$478.63
United
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$380.19
Wellmark
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$72.44
Median
$72.44
Typical High
$112.20
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$28.84
Median
$28.84
Typical High
$44.67

Where Iowa 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.

Iowa· 18th of 51

$200

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.