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Tumor Marker Test, Positive or Negative

Connecticut 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 July 2026.

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

$18.62

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $18.62 for this service. The price depends on where it is billed: about $17.78 from a physician practice, and about $39.81 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$17.78$17.78 to $18.62
FacilityA hospital or hospital-owned outpatient department$39.81$25.70 to $53.70

How much rates vary

Facilitymedian $40 · 10th to 90th $26 to $71Professionalmedian $18 · 10th to 90th $12 to $28
$10$20$50$100facility $40professional $18

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$36.31
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$17.78
Typical High
$26.92
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$39.81
Typical High
$69.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$15.49
Typical High
$30.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$39.81
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$28.18
Typical High
$39.81
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$22.39
Typical High
$33.88
United
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$23.44
Typical High
$44.67

Where Connecticut sits

The same service costs 2.7 times more in South Dakota than in Florida. 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.

Connecticut· 50th of 51

$18.62

SD $48.98FL $18.20

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.