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Moderate-Complexity Genetic Analysis

Utah 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?

$200

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $224 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$162$100 to $234
FacilityA hospital or hospital-owned outpatient department$224$129 to $372

How much rates vary

Facilitymedian $224 · 10th to 90th $100 to $372Professionalmedian $162 · 10th to 90th $100 to $234
$100.0$200.0$500.0$1.0Kfacility $224professional $162

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
$100.00
Median
$371.54
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$234.42
Typical High
$234.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$194.98
Typical High
$512.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$190.55
Typical High
$398.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$213.80
Typical High
$758.58
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$208.93
Select Health
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$162.18
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$186.21

Where Utah 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.

Utah $200 · 19th 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.