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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 October 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$209

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $209 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $209 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$186$145 to $355
FacilityA hospital or hospital-owned outpatient department$209$209 to $355

How much rates vary

Facilitymedian $209 · 10th to 90th $170 to $355Professionalmedian $186 · 10th to 90th $95 to $447
$100$200$500$1Kfacility $209professional $186

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
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$208.93
Aetna
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$123.03
Typical High
$173.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Cigna
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$354.81
Typical High
$446.68
Medica
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$208.93
Typical High
$208.93
Medica
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$165.96
Typical High
$338.84
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$436.52
Typical High
$512.86
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$186.21
Wellmark
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$186.21

Where South Dakota 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.

South Dakota· 14th of 51

$209

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.