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Moderate-Complexity Genetic Analysis

Montana 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?

$269

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $245 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$245$166 to $269
FacilityA hospital or hospital-owned outpatient department$316$275 to $347

How much rates vary

Facilitymedian $316 · 10th to 90th $245 to $437Professionalmedian $245 · 10th to 90th $78 to $331
$100$200$500$1Kfacility $316professional $245

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
$100.00
Median
$213.80
Typical High
$275.42
BCBS Montana
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$1,148.15
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Cigna
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$275.42
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$316.23
Typical High
$371.54
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$316.23
Typical High
$338.84
Providence
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$275.42
Typical High
$1,047.13
Providence
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$269.15
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$186.21

Where Montana 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.

Montana· 5th of 51

$269

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.