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Moderate-Complexity Genetic Analysis

Ohio 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 July 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$174

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $282 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$95.50 to $178
FacilityA hospital or hospital-owned outpatient department$282$195 to $646

How much rates vary

Facilitymedian $282 · 10th to 90th $170 to $741Professionalmedian $148 · 10th to 90th $74 to $372
$100$200$500$1Kfacility $282professional $148

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$371.54
Typical High
$741.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$147.91
Typical High
$446.68
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$251.19
CareSource
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$257.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$245.47
Typical High
$1,071.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$141.25
Typical High
$416.87
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$263.03
Typical High
$1,071.52
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$199.53
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$204.17
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$338.84

Where Ohio sits

The same service costs 4.2 times more in Alaska than in Vermont. 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.

Ohio· 32nd of 51

$174

AK $417VT $100

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.