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Moderate-Complexity Genetic Analysis

New Mexico 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?

$174

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $115 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$115$77.62 to $204
FacilityA hospital or hospital-owned outpatient department$933$437 to $1,122

How much rates vary

Facilitymedian $933 · 10th to 90th $166 to $1,479Professionalmedian $115 · 10th to 90th $78 to $257
$100$200$500$1Kfacility $933professional $115

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
$138.04
Median
$588.84
Typical High
$616.60
Aetna
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$223.87
Typical High
$257.04
BCBS New Mexico
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$977.24
Typical High
$1,548.82
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$151.36
Typical High
$173.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$165.96
Typical High
$416.87
Molina
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
Providence
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Providence
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$245.47
Typical High
$269.15
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
$77.62
Typical High
$112.20

Where New Mexico 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 Mexico· 33rd of 51

$174

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.