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Comparison Gene Sequencing For A Relative

Vermont rates for HCPCS 81416

Reads the protein-coding parts of the genes of a close relative, usually a parent or a sibling, from a blood or saliva sample, so the results can be lined up against the patient's own sequencing. Comparing them shows whether a genetic change found in the patient was inherited or arose new, which is often what separates a harmless variation from the cause of the illness. It is performed and billed in addition to the patient's own sequencing, once for each relative tested.

Rates data updated July 2026.

How much does Comparison Gene Sequencing For A Relative cost?

$1,000

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $1,000 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $12,023 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 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$1,000$1,000 to $1,000
FacilityA hospital or hospital-owned outpatient department$12,023$4,169 to $19,953

How much rates vary

Facilitymedian $12,023 · 10th to 90th $4,169 to $19,953Professionalmedian $1,000 · 10th to 90th $1,000 to $12,023
$1K$2K$5K$10K$20Kfacility $12,023professional $1,000

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
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19,952.62
Median
$19,952.62
Typical High
$19,952.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12,022.64
Median
$14,125.38
Typical High
$26,915.35
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$12,022.64
Typical High
$12,022.64
United
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$5,495.41
Median
$12,022.64
Typical High
$26,302.68

Where Vermont sits

The same service costs 19.1 times more in North Dakota than in Kentucky. 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· 50th of 51

$1,000

ND $18,197KY $955

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.