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Targeted Gene Sequencing Analysis

North Carolina rates for HCPCS 81405

This laboratory analysis examines the DNA sequence of a specific gene associated with an inherited condition, looking for changes that could explain a patient's symptoms or family history. It is one of many single-gene analyzes available, each ordered based on the particular condition being evaluated. Results help confirm a diagnosis or guide further testing and family counseling.

Rates data updated July 2026.

How much does Targeted Gene Sequencing Analysis cost?

$269

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $513 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$240$240 to $363
FacilityA hospital or hospital-owned outpatient department$513$263 to $661

How much rates vary

Facilitymedian $513 · 10th to 90th $240 to $955Professionalmedian $240 · 10th to 90th $182 to $479
$200$500$1Kfacility $513professional $240

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
$239.88
Median
$524.81
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$239.88
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$691.83
Typical High
$851.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$302.00
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$660.69
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$407.38
Medcost
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$269.15
Typical High
$467.74
Medcost
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$354.81
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$331.13
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$2,238.72

Where North Carolina sits

The same service costs 3.9 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.

North Carolina· 30th of 51

$269

AK $676VT $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.