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Tumor Marker Test, Positive or Negative

Idaho 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?

$29.51

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $29.51 for this service. The price depends on where it is billed: about $26.30 from a physician practice, and about $44.67 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$26.30$23.99 to $50.12
FacilityA hospital or hospital-owned outpatient department$44.67$25.70 to $67.61

How much rates vary

Facilitymedian $45 · 10th to 90th $26 to $95Professionalmedian $26 · 10th to 90th $22 to $50
$10$20$50$100facility $45professional $26

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
$45.71
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$29.51
Typical High
$50.12
BCBS
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$64.57
Typical High
$104.71
BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$25.70
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$53.70
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$19.05
Typical High
$36.31
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$33.11
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$30.90
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$51.29
Typical High
$91.20
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$21.88
Typical High
$26.92
Select Health
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$77.62
Select Health
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$11.75
Typical High
$32.36

Where Idaho 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.

Idaho· 11th of 51

$29.51

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.