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Moderate-Complexity Genetic Analysis

Maryland 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?

$138

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $138 for this service. Most negotiated rates run $126 to $148.

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.

How much rates vary

Professionalmedian $138 · 10th to 90th $83 to $186
$100$200$500professional $138

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
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$158.49
CareFirst
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$147.91
Typical High
$154.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$177.83
Typical High
$537.03
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$223.87
Typical High
$275.42
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$93.33
Typical High
$162.18
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
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
$69.18
Typical High
$75.86
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$27.54
Typical High
$30.20

Where Maryland 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.

Maryland· 45th of 51

$138

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.