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Moderate-Complexity Genetic Analysis

Oregon 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?

$204

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $240 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$186$158 to $275
FacilityA hospital or hospital-owned outpatient department$240$186 to $372

How much rates vary

Facilitymedian $240 · 10th to 90th $186 to $513Professionalmedian $186 · 10th to 90th $100 to $363
$100.0$200.0$500.0$1.0Kfacility $240professional $186

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
$269.15
Median
$371.54
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$177.83
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$478.63
Typical High
$537.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$204.17
Typical High
$331.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$398.11
Typical High
$489.78
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$186.21
Typical High
$257.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$204.17
Typical High
$257.04
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$371.54
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$213.80
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$257.04
Typical High
$537.03
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$204.17
Typical High
$281.84
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$549.54
Typical High
$676.08
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$158.49
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$223.87

Where Oregon sits

The same service costs 4.2 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Oregon $204 · 16th of 51
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.