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Moderate-Complexity Genetic Analysis

Rhode Island 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?

$138

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $224 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$117$100 to $186
FacilityA hospital or hospital-owned outpatient department$224$186 to $234

How much rates vary

Facilitymedian $224 · 10th to 90th $166 to $513Professionalmedian $117 · 10th to 90th $98 to $309
$100$200$500facility $224professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$213.80
Typical High
$234.42
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$138.04
Typical High
$398.11
Cigna
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$512.86
Typical High
$562.34
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$251.19
Typical High
$251.19
United
Setting
Facility
Modifier
None
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$309.03

Where Rhode Island 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.

Rhode Island· 44th of 51

$138

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.