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Moderate-Complexity Genetic Analysis

Indiana 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 Indiana, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $186 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 5 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$151$100 to $151
FacilityA hospital or hospital-owned outpatient department$186$186 to $372

How much rates vary

Facilitymedian $186 · 10th to 90th $186 to $550Professionalmedian $151 · 10th to 90th $74 to $214
$10.0$50.0$200.0$1.0Kfacility $186professional $151

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
$151.36
Median
$194.98
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$213.80
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$549.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$147.91
CareSource
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$186.21
Typical High
$257.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$213.80
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$169.82
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$229.09

Where Indiana sits

The same service costs 4.2 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Indiana $155 · 39th of 51
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.