go back

Tumor Marker Test, Positive or Negative

Georgia 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?

$20.89

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $20.89 for this service. The price depends on where it is billed: about $16.98 from a physician practice, and about $30.90 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 6 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$16.98$15.49 to $23.44
FacilityA hospital or hospital-owned outpatient department$30.90$20.42 to $37.15

How much rates vary

Facilitymedian $31 · 10th to 90th $15 to $54Professionalmedian $17 · 10th to 90th $11 to $29
$10$20$50$100facility $31professional $17

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
$14.13
Median
$28.84
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$20.42
Typical High
$28.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$30.90
Typical High
$40.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$15.49
Typical High
$26.30
CareSource
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$51.29
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$22.39
Typical High
$38.90
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$36.31
Typical High
$48.98
United
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$22.91
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$11.48
Typical High
$27.54

Where Georgia 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.

Georgia· 39th of 51

$20.89

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.