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Highly Complex Genetic Laboratory Analysis

Rhode Island rates for HCPCS 81407

This represents one of the most technically complex levels of gene-based laboratory analysis available, used when evaluating certain inherited conditions or cancer-related genetic changes that require especially involved laboratory work to identify. The complexity reflects factors such as the size of the genetic region examined and the analytic methods required, rather than testing for one single, simple genetic change. It requires only a blood or tissue sample.

Rates data updated July 2026.

How much does Highly Complex Genetic Laboratory Analysis cost?

$1,202

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $1,202 for this service. The price depends on where it is billed: about $1,202 from a physician practice, and about $1,023 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 4 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$1,202$631 to $1,202
FacilityA hospital or hospital-owned outpatient department$1,023$977 to $1,259

How much rates vary

Facilitymedian $1,023 · 10th to 90th $851 to $4,898Professionalmedian $1,202 · 10th to 90th $631 to $1,202
$500$1K$2K$5Kfacility $1,023professional $1,202

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
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$977.24
Typical High
$1,071.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,949.84
Typical High
$2,344.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,949.84
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,174.90
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$1,230.27

Where Rhode Island sits

The same service costs 3.0 times more in Alaska than in Washington, DC. 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.

Rhode Island· 4th of 51

$1,202

AK $1,905DC $631

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.