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Moderate-Complexity Genetic Analysis

Kentucky 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?

$148

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $126 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$126$74.13 to $170
FacilityA hospital or hospital-owned outpatient department$186$151 to $295

How much rates vary

Facilitymedian $186 · 10th to 90th $151 to $447Professionalmedian $126 · 10th to 90th $74 to $251
$100$200$500$1Kfacility $186professional $126

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
$151.36
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$147.91
Typical High
$251.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$186.21
CareSource
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$257.04
Typical High
$354.81
CareSource
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$239.88
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$512.86
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$891.25
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$1,949.84
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$186.21

Where Kentucky 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.

Kentucky· 44th of 51

$148

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.