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Tumor Marker Test, Positive or Negative

Iowa 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.

Facilitymedian $40 · 10th–90th $19$710%10%20%10th90th$40Professionalmedian $22 · 10th–90th $16$560%10%20%10th90th$22$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$48.98
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$20.89
Typical High
$37.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$48.98
Typical High
$61.66
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$47.86
Typical High
$66.07
Medica
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$30.90
Typical High
$70.79
Medica
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$25.70
Typical High
$56.23
Midlands
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$30.90
Typical High
$30.90
Midlands
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
United
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$16.60
Typical High
$58.88
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$25.70
Typical High
$25.70