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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 October 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$148

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $186 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$112$74.13 to $186
FacilityA hospital or hospital-owned outpatient department$186$166 to $407

How much rates vary

Facilitymedian $186 · 10th to 90th $148 to $562Professionalmedian $112 · 10th to 90th $74 to $275
$100$200$500$1K$2Kfacility $186professional $112

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
$151.36
Median
$275.42
Typical High
$676.08
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$151.36
Typical High
$275.42
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$186.21
Typical High
$549.54
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$275.42
CareSource
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$204.17
Typical High
$257.04
Cigna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$186.21
Typical High
$524.81
Cigna
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$165.96
Typical High
$354.81
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$309.03
Median
$467.74
Typical High
$2,187.76
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$158.49
Typical High
$281.84
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$223.87
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
$69.18
Median
$75.86
Typical High
$138.04
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$30.20
Typical High
$54.95

Where Indiana 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.

Indiana· 41st of 51

$148

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.