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Genetic Test For A Specific Gene Change

Vermont rates for HCPCS 81404

This is a laboratory test that analyzes a particular gene to look for a specific genetic change linked to an inherited condition or a disease risk. Which gene is examined depends on the medical reason the test was ordered, such as a family history of a certain condition or a diagnosis that needs genetic confirmation. The analysis involves techniques of moderate technical complexity compared with simpler single-variant genetic checks.

Rates data updated July 2026.

How much does Genetic Test For A Specific Gene Change cost?

$174

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $603 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 5 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$174$174 to $174
FacilityA hospital or hospital-owned outpatient department$603$457 to $692

How much rates vary

Facilitymedian $603 · 10th to 90th $275 to $692Professionalmedian $174 · 10th to 90th $174 to $331
$200$500facility $603professional $174

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. 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
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$691.83
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$323.59
Typical High
$616.60
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$602.56

Where Vermont sits

The same service costs 3.5 times more in Alaska than in Rhode Island. 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.

Vermont· 50th of 51

$174

AK $617RI $174

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.