go back

Tumor Marker Test, Positive or Negative

Florida 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?

$18.20

Typical negotiated rate. In Florida, July 2026.

Insurers have agreed to pay about $18.20 for this service. The price depends on where it is billed: about $17.78 from a physician practice, and about $46.77 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 7 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$16.22 to $18.62
FacilityA hospital or hospital-owned outpatient department$46.77$24.55 to $74.13

How much rates vary

Facilitymedian $47 · 10th to 90th $19 to $102Professionalmedian $18 · 10th to 90th $16 to $23
$10$20$50$100facility $47professional $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
$21.88
Median
$63.10
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$17.78
Typical High
$21.88
AvMed
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$25.70
Typical High
$30.20
AvMed
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$25.70
Typical High
$27.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$23.99
Typical High
$74.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$22.39
Typical High
$45.71
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$46.77
Typical High
$46.77
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$26.92
Typical High
$32.36
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.09
Median
$12.30
Typical High
$15.49
United
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$22.91
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$12.02
Typical High
$27.54
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$15.49

Where Florida 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.

Florida· 51st of 51

$18.20

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.