go back

Tumor Marker Test, Positive or Negative

Minnesota 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?

$29.51

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $29.51 for this service. The price depends on where it is billed: about $29.51 from a physician practice, and about $25.70 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$29.51$23.99 to $37.15
FacilityA hospital or hospital-owned outpatient department$25.70$23.99 to $69.18

How much rates vary

Facilitymedian $26 · 10th to 90th $24 to $120Professionalmedian $30 · 10th to 90th $11 to $54
$10$20$50$100$200facility $26professional $30

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Aetna
Setting
Professional
Modifier
None
Typical Low
$23.99
Median
$23.99
Typical High
$30.90
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$24.55
Median
$25.70
Typical High
$104.71
BCBS Minnesota
Setting
Professional
Modifier
QW · Waived lab test
Typical Low
$20.42
Median
$22.91
Typical High
$25.70
Cigna
Setting
Facility
Modifier
None
Typical Low
$30.20
Median
$81.28
Typical High
$239.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$29.51
Median
$37.15
Typical High
$48.98
Health Partners
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$79.43
Typical High
$186.21
Health Partners
Setting
Professional
Modifier
None
Typical Low
$29.51
Median
$29.51
Typical High
$48.98
Medica
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$40.74
Typical High
$120.23
Medica
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$22.91
Typical High
$54.95
United
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$30.90
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$23.44
Typical High
$60.26
4 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
Facility
Modifier
52 · Reduced service
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$4.79
Median
$4.79
Typical High
$4.79
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$12.02
Median
$12.02
Typical High
$15.49
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$4.79
Median
$4.79
Typical High
$6.17

Where Minnesota 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.

Minnesota· 13th of 51

$29.51

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.