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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 October 2026.

How much does Targeted Gene Sequencing Analysis cost?

$302

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $302 from a physician practice, and about $661 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$302$257 to $479
FacilityA hospital or hospital-owned outpatient department$661$240 to $933

How much rates vary

Facilitymedian $661 · 10th to 90th $240 to $1,380Professionalmedian $302 · 10th to 90th $182 to $794
$200$500$1Kfacility $661professional $302

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
$239.88
Median
$239.88
Typical High
$501.19
Aetna
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$239.88
Typical High
$363.08
BCBS North Carolina
Setting
Facility
Modifier
None
Typical Low
$676.08
Median
$912.01
Typical High
$933.25
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$331.13
Typical High
$954.99
Cigna
Setting
Facility
Modifier
None
Typical Low
$229.09
Median
$660.69
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$208.93
Typical High
$457.09
Medcost
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$239.88
Typical High
$354.81
Medcost
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$512.86
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$181.97
Typical High
$316.23
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$117.49
Median
$120.23
Typical High
$181.97
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$46.77
Median
$47.86
Typical High
$72.44
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$151.36
Median
$151.36
Typical High
$416.87

Where North Carolina sits

The same service costs 3.9 times more in Alaska than in Alabama. 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· 27th of 51

$302

AK $676AL $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.