Planning for a child comes with many uncertainties, but genetic testing can identify potential health risks early. Natera specializes in prenatal and carrier screening, giving parents-to-be insight into possible genetic conditions before or during pregnancy. With this information, they can make informed decisions about their child's health and future.
Two of Natera’s most well-known tests are Horizon and Panorama. Horizon helps identify whether you or your partner carry genetic conditions that could be passed down, while Panorama analyzes fetal DNA to screen for conditions like Down syndrome.
This Natera Horizon vs. Panorama comparison will analyze how these tests differ and what each one offers. You’ll learn how the testing process works and what insights each test provides. We’ll also explore reviews from people who have taken these tests.
Natera Horizon vs. Panorama: The basics
Get to know the main characteristics of Horizon and Panorama before we investigate them in greater detail:
Horizon: Carrier screening test
Horizon can help prospective parents understand if they’re carriers of any diseases or conditions that they may pass on to their children. The test screens for:
Recessive genetic conditions: These occur when the child inherits the gene from both parents. Conditions like spinal muscular atrophy can be passed down this way. If both parents are carriers, there’s a 25% chance this could affect the child
X-linked conditions: These conditions, which include Duchenne muscular dystrophy, occur when the female parent is a carrier. In that case, the child has a 50% chance of being affected by the condition
Source: Natera
Horizon is intended for individuals planning to conceive or those who are already expecting. Typically, the mother takes the test first. If the result is positive, the father gets screened for the same condition to confirm the risk. Alternatively, the parents can take the test at the same time for efficiency’s sake.
Here’s how the Horizon testing process works:
Speak with a healthcare provider. They’ll discuss your family history and other relevant factors and then order the appropriate test panel
Next, you (and your partner) will provide a blood or saliva sample
Once your results are ready, Natera will forward them to your provider, who will inform you of the findings. You can track your sample through the testing process via Natera’s online patient portal
Note that a positive result isn’t a diagnosis — it only indicates increased risk and doesn’t guarantee the child will experience health problems. If the result raises concern, your physician will likely order additional testing, such as Panorama.
Panorama: Non-invasive prenatal test (NIPT)
Panorama is a prenatal screening test that analyzes cell-free DNA (cfDNA) — fragments from the placenta that enter the mother’s bloodstream. Based on a blood sample, Panorama can measure cfDNA levels and predict the child’s sex and the likelihood of conditions like Down syndrome.
Natera’s NIPT is unique because it’s the only test that screens for triploidy. It also analyzes single nucleotide polymorphisms (SNPs) — genetic variations among individuals that occur at a single location. This allows it to detect the zygosity of twins, i.e., determine if they’re identical or fraternal.
Source: MART PRODUCTION
Panorama is available starting at nine weeks of pregnancy, following a consultation with your physician. If you decide to take both Horizon and Panorama, you’ll only need to provide one blood sample.
Like with Horizon, your doctor will share your results, typically over the phone or at your next appointment. Since Panorama is a screening test, your doctor may recommend additional tests, such as amniocentesis, to confirm the results.
Natera offers other prenatal and women’s health tests, including:
Vistara: A test that screens for more common, single-gene conditions, which benefit from early detection and intervention
Spectrum: A preimplantation genetic test that aims to improve the chances of a successful in-vitro fertilization (IVF)
Bonus read — Find out how Natera’s prenatal tests compare to Labcorp’s MaterniT 21 PLUS and how the service compares to Invitae and Myriad Genetics.
Natera Horizon vs. Panorama: A closer look
The following sections will provide an in-depth breakdown of Panorama’s and Horizon’s key aspects, specifically their:
Scope of analysis
Technology and accuracy
Cost and insurance coverage
User reviews
1. Scope of analysis
Horizon and Panorama are fundamentally distinct tests and thus target different conditions. The Panorama panel screens for 13 conditions in total — learn which ones below:
Horizon offers customizable and pre-built panels, which vary in terms of the number of conditions they target. The most basic one screens for four conditions, while the most comprehensive one covers over 600 conditions. Still, the standard panel is Horizon 14, which tests for 14 relatively common conditions, including:
Canavan disease
Cystic fibrosis
Fragile X syndrome
Spinal muscular atrophy
Tay-Sachs disease
Tip 💡
While Horizon and Panorama are comprehensive tests in their respective areas, they analyze only a small portion of your DNA. For a more holistic insight into your genetic makeup, opt for a whole-genome test like Nucleus Premium.
Nucleus analyzes nearly 100% of your DNA, including rare and high-effect genetic variants that can significantly affect your or your child’s health. With only one simple and painless test, Nucleus can screen for over 800 diseases and conditions, including cystic fibrosis, Tay-Sachs disease, cancer, and even mental health conditions.
Your results will be easy to understand and include personalized advice, helping you make the best decisions on lifestyle, healthcare, and family planning. Order your test kit today!
2. Technology and accuracy
Natera has over two decades of experience in genetic testing, and its tests are trusted by healthcare providers worldwide. Natera’s labs are CLIA-certified and CAP-accredited, so they follow strict protocols for quality of analysis.
Natera primarily uses next-generation sequencing (NGS) technology, an advanced method that offers greater accuracy and reliability compared to genotyping tests like 23andMe and tellmeGen.
Natera claims its tests are highly sensitive and accurate, especially Panorama, thanks to its unique SNP algorithm. The test has been reported to achieve high scores in validation studies:
99% sensitivity for trisomies (high detection rate for trisomies like Down syndrome)
83% sensitivity for 22q11.2 deletions (high detection rate for 22q11.2 deletion syndrome)
Zero fetal sex errors
Source: Natera
That said, Panorama may produce inconclusive results for some women, especially those with a higher BMI. A significant number of users have reported inaccurate results, where positive results were later disproven through additional analyses after childbirth.
Experts, including the FDA, have warned users about NIPTs, claiming that they often produce false positive results and can lead to unnecessary worry and invasive procedures.
Check out one mother’s experience below:
Meanwhile, we found no user complaints regarding the accuracy of Horizon test results.
3. Cost and insurance coverage
The exact pricing of Panorama and Horizon isn’t publicly disclosed, but Natera lists that self-pay options for women’s health tests typically range from $249 to $349. The company works with most major health insurance providers and claims that two-thirds of users incur no out-of-pocket costs. For those facing financial difficulties, Natera offers a financial assistance program that can reduce the cost to $149 or less, depending on household size and income.
Despite many attempts to make its tests more affordable, Natera has faced significant criticism and was even sued by users for its billing practices. Many users report receiving unexpectedly high bills despite being told their costs would be low or non-existent, though some may have mistaken the explanation of benefits (EOB) for an actual bill.
While many successfully appealed the cost, others received collection warnings. Read one such user’s story below:
Before testing, make sure to discuss the pricing with your physician and insurance provider and request a cost estimate from Natera.
Bonus read — Discover the pricing models of other testing services:
4. User reviews
Although it has an A+ grade with the Better Business Bureau (BBB), Natera isn’t BBB-accredited. Also, many Natera customers have expressed discontent on BBB’s website, which resulted in:
A 2.2/5 rating from 528 reviews
664 complaints in the previous three years
Many users claim that the testing process was smooth and that Natera’s representatives were helpful and patient. Still, negative reviews, specifically those related to NIPT results and billing, are far more prevalent. Besides these issues, users have reported:
Occasional delays in turnaround
Difficulty reaching customer support
Technical mishaps with the online portal
Final thoughts on the Natera Panorama vs. Horizon analysis
Panorama and Horizon are popular screening tests that have proven useful for many families. Still, be mindful of potential issues with Panorama results and Natera’s billing practices to avoid surprises.
Before you get the test, it’s best to:
Consult your doctor to choose the best test and panel and interpret your results
Ask Natera for a clear cost estimate and explanation of the billing process
Get a genetic consultation for additional expert insights
For a carrier screening test with simple pricing, go with Nucleus Premium. For only $399, Nucleus will analyze nearly your whole genome, including rare variants that Natera overlooks, and screen for hundreds of inheritable diseases and conditions.
While the test is physician-ordered, Nucleus’ partnership with SteadyMD allows you to order it directly online and take it at home in minutes. You’ll receive detailed and actionable reports, and you can request a consultation with a board-certified genetic counselor for additional insights or guidance.
Nucleus: All-in-one DNA insights to guide your family planning
Nucleus offers a comprehensive test to help you understand your health risks and carrier status for over 800 diseases and conditions, spanning categories such as:
Cancer
Heart health
Neurology
Food and diet
Mental health
Besides screening for more conditions than Horizon, Nucleus analyzes nearly 100% of your DNA as opposed to select genes. Using the latest sequencing technology, it can provide 99.9% accurate results. Unlike most other genetic testing companies, Nucleus considers lifestyle factors, such as your alcohol intake, to calculate your absolute risk and personalize the reports further.
The results are designed to be easy to understand. You’ll also get access to Nucleus AI, which offers personalized health tips based on your genetic and non-genetic data.
Shape your future with Nucleus Premium
Although more comprehensive than Horizon, Nucleus Premium is only $399 and includes all 800+ analyses and free shipping. While insurance doesn’t cover the test, you can use your HSA/FSA funds to pay for it and potentially reduce the total cost.
As DNA insights are for life, you only need to test once. Still, you can choose to receive updated results as Nucleus upgrades its database and learns about your lifestyle changes.
Here’s how you can get started with Nucleus:
Provide your personal information
Order the test kit
Once your kit arrives, you only need to swab your cheeks and mail the sample to the Nucleus lab. You should receive your results online within six to eight weeks. Note that Nucleus is HIPAA-compliant, so you don’t need to worry about the safety or privacy of your data.
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Featured image source: Patty Brito
