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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.

Facilitymedian $25 · 10th–90th $24$450%50%10th90th$25Professionalmedian $21 · 10th–90th $17$300%20%10th90th$21$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$44.67
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$23.99
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
$23.99
Median
$24.55
Typical High
$44.67
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$24.55
Typical High
$33.88
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$15.14
Typical High
$30.20
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
$22.39