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Tumor Marker Test, Positive or Negative

Maryland 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 October 2026.

How much does Tumor Marker Test, Positive or Negative cost?

$19.05

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $19.05 for this service. Most negotiated rates run $16.22 to $20.42.

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.

How much rates vary

Facilitymedian $17 · 10th to 90th $13 to $33Professionalmedian $19 · 10th to 90th $11 to $26
$10$20$50facility $17professional $19

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.05
Median
$19.05
Typical High
$19.50
CareFirst
Setting
Professional
Modifier
None
Typical Low
$18.62
Median
$20.42
Typical High
$20.42
Cigna
Setting
Facility
Modifier
None
Typical Low
$13.18
Median
$16.98
Typical High
$33.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$22.39
Typical High
$63.10
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$29.51
Typical High
$38.02
United
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$12.88
Typical High
$21.38
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$9.55
Median
$9.55
Typical High
$9.55
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.80
Median
$3.80
Typical High
$3.80

Where Maryland sits

The same service costs 3.8 times more in Alaska than in Alabama. 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.

Maryland· 42nd of 51

$19.05

AK $57.54AL $15.14

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.