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Tumor Marker Test, Positive or Negative

Illinois 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?

$25.70

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $25.70 for this service. The price depends on where it is billed: about $21.88 from a physician practice, and about $41.69 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$21.88$15.85 to $25.70
FacilityA hospital or hospital-owned outpatient department$41.69$26.30 to $52.48

How much rates vary

Facilitymedian $42 · 10th to 90th $22 to $89Professionalmedian $22 · 10th to 90th $3 to $50
$5$10$20$50$100$200facility $42professional $22

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
$20.89
Median
$39.81
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$21.88
Typical High
$52.48
BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$51.29
Typical High
$309.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$19.50
Typical High
$25.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$53.70
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$29.51
Typical High
$41.69
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$44.67
Typical High
$114.82
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$17.78
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$25.70
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$14.13
Typical High
$25.70

Where Illinois 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.

Illinois· 25th of 51

$25.70

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.