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Moderate-Complexity Genetic Analysis

South Dakota 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?

$214

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $214 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $355 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 6 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$112 to $398
FacilityA hospital or hospital-owned outpatient department$355$355 to $355

How much rates vary

Facilitymedian $355 · 10th to 90th $209 to $389Professionalmedian $186 · 10th to 90th $95 to $447
$100$200$500facility $355professional $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
$128.82
Median
$389.05
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$123.03
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$354.81
Typical High
$446.68
Medica
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$208.93
Typical High
$398.11
Medica
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$933.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$436.52
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$245.47
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21

Where South Dakota 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.

South Dakota· 13th of 51

$214

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.