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Targeted Gene Sequencing Analysis

New York 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?

$288

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $537 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 10 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$288$182 to $407
FacilityA hospital or hospital-owned outpatient department$537$302 to $776

How much rates vary

Facilitymedian $537 · 10th to 90th $229 to $955Professionalmedian $288 · 10th to 90th $135 to $646
$20$50$100$200$500$1K$2Kfacility $537professional $288

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$371.54
Typical High
$1,318.26
Aetna
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$257.04
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$776.25
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$389.05
Typical High
$691.83
CDPHP
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$758.58
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$363.08
Typical High
$1,445.44
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$501.19
Typical High
$831.76
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$257.04
Typical High
$436.52
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$288.40
Typical High
$346.74
MVP Health Care
Setting
Facility
Modifier
None
Typical Low
$13.80
Median
$257.04
Typical High
$602.56
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$616.60
Typical High
$645.65
United
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$302.00
Typical High
$380.19
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$147.91
Typical High
$457.09
Univera
Setting
Facility
Modifier
None
Typical Low
$31.62
Median
$194.98
Typical High
$316.23
Univera
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$288.40
Typical High
$338.84
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
$87.10
Median
$87.10
Typical High
$128.82
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$34.67
Median
$34.67
Typical High
$51.29
Highmark BCBS
Setting
Facility
Modifier
22 · Increased work
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48

Where New York 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.

New York· 29th of 51

$288

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.