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Moderate-Complexity Genetic Analysis

New Jersey 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?

$129

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $933 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$117$100 to $129
FacilityA hospital or hospital-owned outpatient department$933$240 to $10,471

How much rates vary

Facilitymedian $933 · 10th to 90th $100 to $19,953Professionalmedian $117 · 10th to 90th $91 to $174
$100$500$2K$10Kfacility $933professional $117

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
$100.00
Median
$100.00
Typical High
$100.00
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$158.49
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$50.12
Median
$50.12
Typical High
$77.62
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$19.95
Median
$19.95
Typical High
$30.90
AmeriHealth
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$588.84
Typical High
$6,165.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$512.86
Typical High
$912.01
Cigna
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$199.53
Typical High
$275.42
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$239.88
Typical High
$269.15
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$4,365.16
Median
$14,791.08
Typical High
$26,915.35
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
United
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$112.20
Typical High
$186.21

Where New Jersey 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.

New Jersey· 48th of 51

$129

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.