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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 October 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$148

Typical negotiated rate. In Ohio, October 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $275 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$100$74.13 to $182
FacilityA hospital or hospital-owned outpatient department$275$195 to $407

How much rates vary

Facilitymedian $275 · 10th to 90th $170 to $759Professionalmedian $100 · 10th to 90th $74 to $295
$100$200$500$1K$2Kfacility $275professional $100

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
$194.98
Median
$501.19
Typical High
$831.76
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$87.10
Median
$204.17
Typical High
$416.87
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$34.67
Median
$81.28
Typical High
$165.96
Aetna
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$758.58
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$74.13
Median
$74.13
Typical High
$380.19
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$29.51
Median
$29.51
Typical High
$151.36
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$213.80
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$245.47
CareSource
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$251.19
Cigna
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$239.88
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$331.13
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$263.03
Typical High
$2,089.30
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$331.13
Molina
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$165.96
Typical High
$229.09
SummaCare
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$229.09
Typical High
$295.12
United
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$165.96
Typical High
$275.42
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$263.03

Where Ohio 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.

Ohio· 39th of 51

$148

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.