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Moderate-Complexity Genetic Analysis

Missouri 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?

$178

Typical negotiated rate. In Missouri, October 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $316 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$174$129 to $295
FacilityA hospital or hospital-owned outpatient department$316$186 to $501

How much rates vary

Facilitymedian $316 · 10th to 90th $162 to $871Professionalmedian $174 · 10th to 90th $93 to $468
$100$200$500$1Kfacility $316professional $174

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
$158.49
Median
$204.17
Typical High
$338.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$177.83
Typical High
$213.80
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$851.14
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$177.83
Typical High
$407.38
BCBS Kansas City
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$288.40
Typical High
$501.19
BCBS Kansas City
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$186.21
Typical High
$354.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$416.87
Typical High
$588.84
Cigna
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$177.83
Typical High
$239.88
Medica
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$323.59
Typical High
$870.96
Medica
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$190.55
Typical High
$933.25
United
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$251.19
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
$79.43
Median
$79.43
Typical High
$107.15
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$31.62
Median
$31.62
Typical High
$42.66

Where Missouri 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.

Missouri· 30th of 51

$178

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.