go back

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 July 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$200

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $288 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$178$141 to $355
FacilityA hospital or hospital-owned outpatient department$288$186 to $490

How much rates vary

Facilitymedian $288 · 10th to 90th $141 to $537Professionalmedian $178 · 10th to 90th $112 to $1,230
$100$200$500$1Kfacility $288professional $178

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
$141.25
Median
$416.87
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$162.18
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$354.81
Typical High
$446.68
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$323.59
Typical High
$660.69
Medica
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$223.87
Typical High
$478.63
Medica
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$190.55
Typical High
$741.31
Midlands
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$245.47
Typical High
$245.47
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$199.53
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$426.58
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$549.54
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21

Where Iowa 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.

Iowa· 18th of 51

$200

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.