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Moderate-Complexity Genetic Analysis

Michigan 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 Michigan, October 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $182 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$138$112 to $178
FacilityA hospital or hospital-owned outpatient department$182$178 to $251

How much rates vary

Facilitymedian $182 · 10th to 90th $138 to $324Professionalmedian $138 · 10th to 90th $89 to $200
$10$20$50$100$200$500facility $182professional $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
Facility
Modifier
None
Typical Low
$177.83
Median
$177.83
Typical High
$275.42
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$87.10
Median
$87.10
Typical High
$138.04
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$35.48
Median
$35.48
Typical High
$54.95
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$181.97
Typical High
$218.78
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$85.11
Median
$91.20
Typical High
$93.33
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$33.88
Median
$36.31
Typical High
$37.15
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$194.98
Typical High
$346.74
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$138.04
Typical High
$138.04
CareSource
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
CareSource
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$204.17
Typical High
$251.19
Cigna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$186.21
Typical High
$251.19
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$218.78
Typical High
$323.59
Health Alliance Plan
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$87.10
Median
$87.10
Typical High
$138.04
Health Alliance Plan
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$35.48
Median
$35.48
Typical High
$54.95
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$138.04
Typical High
$213.80
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Priority Health
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$186.21
Typical High
$251.19
United
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$165.96
Typical High
$223.87
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$186.21

Where Michigan 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.

Michigan· 46th 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.