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Tumor Marker Test, Positive or Negative

Washington, DC 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?

$19.05

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $19.05 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $43.65 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$19.05$19.05 to $19.05
FacilityA hospital or hospital-owned outpatient department$43.65$19.05 to $81.28

How much rates vary

Facilitymedian $44 · 10th to 90th $19 to $123Professionalmedian $19 · 10th to 90th $19 to $60
$10$20$50$100$200facility $44professional $19

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
$19.05
Median
$64.57
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$89.13
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$43.65
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$30.90
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$52.48
United
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$30.90
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$29.51

Where Washington, DC 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.

Washington, DC· 47th of 51

$19.05

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.