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Genetic Test, Higher Complexity Gene Analysis

Vermont rates for HCPCS 81406

This is a laboratory test that analyzes a specific gene in detail to check for a change linked to an inherited condition or disease risk. The particular gene studied depends on the clinical reason it was ordered. It involves more extensive laboratory work than many other single-gene tests, reflecting a more thorough analysis of the gene's structure.

Rates data updated July 2026.

How much does Genetic Test, Higher Complexity Gene Analysis cost?

$100

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $2,570 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$100$100 to $100
FacilityA hospital or hospital-owned outpatient department$2,570$479 to $2,884

How much rates vary

Facilitymedian $2,570 · 10th to 90th $282 to $2,884Professionalmedian $100 · 10th to 90th $100 to $282
$100$200$500$1K$2Kfacility $2,570professional $100

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
$100.00
Median
$100.00
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$2,570.40
Typical High
$2,630.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$2,884.03
Typical High
$2,884.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$630.96
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$323.59
Typical High
$616.60

Where Vermont sits

The same service costs 6.3 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.

Vermont· 51st of 51

$100

AK $631VT $100

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.