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Tumor Marker Test, Positive or Negative

Arizona 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?

$20.42

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $20.42 for this service. The price depends on where it is billed: about $13.49 from a physician practice, and about $50.12 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$13.49$11.22 to $16.98
FacilityA hospital or hospital-owned outpatient department$50.12$21.88 to $75.86

How much rates vary

Facilitymedian $50 · 10th to 90th $16 to $117Professionalmedian $13 · 10th to 90th $11 to $27
$10$20$50$100facility $50professional $13

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
$19.50
Median
$81.28
Typical High
$131.83
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$14.45
Median
$66.07
Typical High
$100.00
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$13.49
Median
$21.38
Typical High
$30.90
Cigna
Setting
Facility
Modifier
None
Typical Low
$16.98
Median
$50.12
Typical High
$70.79
Cigna
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$23.44
Typical High
$38.90
Medica
Setting
Facility
Modifier
None
Typical Low
$16.98
Median
$25.70
Typical High
$120.23
Medica
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$11.48
Typical High
$20.42
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$11.48
Typical High
$25.70
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
$8.51
Median
$8.51
Typical High
$8.51
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.47
Median
$3.47
Typical High
$3.47

Where Arizona 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.

Arizona· 36th of 51

$20.42

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.