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Tumor Marker Test, Positive or Negative

Michigan 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?

$24.55

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $24.55 for this service. The price depends on where it is billed: about $24.55 from a physician practice, and about $24.55 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$24.55$19.05 to $24.55
FacilityA hospital or hospital-owned outpatient department$24.55$24.55 to $30.20

How much rates vary

Facilitymedian $25 · 10th to 90th $23 to $45Professionalmedian $25 · 10th to 90th $18 to $30
$10$20$50facility $25professional $25

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
$22.91
Median
$24.55
Typical High
$44.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$24.55
Typical High
$30.20
BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$28.84
Typical High
$51.29
BCBS
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$19.05
Typical High
$19.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$29.51
Typical High
$36.31
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$24.55
Typical High
$52.48
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$23.99
Typical High
$32.36
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$30.90
United
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$25.70
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$13.18
Typical High
$25.70

Where Michigan 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.

Michigan· 27th of 51

$24.55

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.