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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 October 2026.

How much does Moderate-Complexity Genetic Analysis cost?

$141

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $200 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$129$100 to $186
FacilityA hospital or hospital-owned outpatient department$200$100 to $224

How much rates vary

Facilitymedian $200 · 10th to 90th $100 to $676Professionalmedian $129 · 10th to 90th $78 to $224
$100$200$500$1Kfacility $200professional $129

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
$100.00
Median
$100.00
Typical High
$100.00
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$50.12
Median
$162.18
Typical High
$208.93
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$19.95
Median
$64.57
Typical High
$85.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$144.54
Cigna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$199.53
Typical High
$524.81
Cigna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$190.55
Typical High
$338.84
Molina
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$141.25
Typical High
$407.38
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$213.80
Typical High
$870.96
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$186.21
Select Health
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$204.17
Typical High
$275.42
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$112.20
Typical High
$112.20

Where Utah 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.

Utah· 42nd of 51

$141

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.