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Moderate-Complexity Genetic Analysis

Pennsylvania 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.

Facilitymedian $309 · 10th–90th $158$6920%20%10th90th$309Professionalmedian $151 · 10th–90th $100$3890%20%10th90th$151$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$380.19
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$467.74
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$213.80
Typical High
$2,041.74
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$912.01
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$302.00
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$199.53
Typical High
$416.87
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$239.88
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$239.88
Typical High
$407.38
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$501.19
Typical High
$1,548.82
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$208.93
Typical High
$446.68
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$380.19
Typical High
$630.96
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$549.54
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$758.58
Typical High
$1,288.25
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$275.42