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Tumor Marker Test, Positive or Negative

Kentucky 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?

$20.42

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $20.42 for this service. The price depends on where it is billed: about $20.42 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$20.42$17.38 to $23.44
FacilityA hospital or hospital-owned outpatient department$25.70$20.89 to $50.12

How much rates vary

Facilitymedian $26 · 10th to 90th $21 to $62Professionalmedian $20 · 10th to 90th $13 to $29
$10$20$50$100facility $26professional $20

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
$20.89
Typical High
$61.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$25.70
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$25.70
Typical High
$26.92
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$17.38
Typical High
$28.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$30.90
Typical High
$35.48
CareSource
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$31.62
Typical High
$51.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$50.12
Typical High
$53.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$123.03
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$25.70
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$28.18

Where Kentucky 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.

Kentucky· 43rd of 51

$20.42

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.