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Moderate-Complexity Genetic Analysis

Maine 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?

$151

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $151 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $229 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$120$112 to $186
FacilityA hospital or hospital-owned outpatient department$229$178 to $269

How much rates vary

Facilitymedian $229 · 10th to 90th $151 to $1,514Professionalmedian $120 · 10th to 90th $95 to $269
$100$200$500$1K$2Kfacility $229professional $120

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
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$151.36
Typical High
$204.17
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$245.47
Typical High
$1,659.59
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$112.20
Typical High
$208.93
Cigna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$416.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$186.21
Typical High
$186.21
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$186.21
Typical High
$323.59
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$151.36
Typical High
$204.17
United
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$323.59

Where Maine 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.

Maine· 38th of 51

$151

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.