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Tumor Marker Test, Positive or Negative

Alabama rates for HCPCS 86294

An antibody-based laboratory test that looks for a tumor-associated substance in a sample and reports the answer as positive or negative, or as a rough level, rather than an exact figure. A common use is checking urine for a bladder cancer marker in someone being monitored after treatment.

Rates data updated October 2026.

How much does Tumor Marker Test, Positive or Negative cost?

$15.14

Typical negotiated rate. In Alabama, October 2026.

Insurers have agreed to pay about $15.14 for this service. The price depends on where it is billed: about $15.49 from a physician practice, and about $15.14 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$15.49$11.22 to $29.51
FacilityA hospital or hospital-owned outpatient department$15.14$15.14 to $15.14

How much rates vary

Facilitymedian $15 · 10th to 90th $15 to $21Professionalmedian $15 · 10th to 90th $11 to $30
$10$20$50$100facility $15professional $15

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
$29.51
Median
$29.51
Typical High
$39.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$29.51
Typical High
$29.51
BCBS Alabama
Setting
Facility
Modifier
None
Typical Low
$15.14
Median
$15.14
Typical High
$15.14
BCBS Alabama
Setting
Professional
Modifier
21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers
Typical Low
$10.00
Median
$12.30
Typical High
$14.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$20.89
Median
$21.38
Typical High
$81.28
Cigna
Setting
Professional
Modifier
None
Typical Low
$11.75
Median
$17.78
Typical High
$112.20
United
Setting
Facility
Modifier
None
Typical Low
$9.12
Median
$22.91
Typical High
$25.70
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$11.22
Typical High
$15.49
2 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
$10.47
Median
$14.79
Typical High
$14.79
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$4.17
Median
$5.89
Typical High
$5.89

Where Alabama sits

The same service costs 3.8 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.

Alabama· 51st of 51

$15.14

AK $57.54AL $15.14

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.