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Tumor Marker Test, Positive or Negative

Indiana 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 Indiana, July 2026.

Insurers have agreed to pay about $20.89 for this service. The price depends on where it is billed: about $20.89 from a physician practice, and about $25.70 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 5 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$20.89$15.49 to $20.89
FacilityA hospital or hospital-owned outpatient department$25.70$25.70 to $51.29

How much rates vary

Facilitymedian $26 · 10th to 90th $26 to $76Professionalmedian $21 · 10th to 90th $10 to $23
$10$20$50$100$200facility $26professional $21

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
$28.18
Typical High
$75.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$20.89
Typical High
$22.91
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$75.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$12.88
Typical High
$18.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$25.70
Typical High
$47.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$22.91
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$25.70
Typical High
$29.51
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$28.18

Where Indiana 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.

Indiana· 38th 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.