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Tumor Marker Test, Positive or Negative

Missouri 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?

$25.70

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $25.70 for this service. The price depends on where it is billed: about $22.39 from a physician practice, and about $33.11 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$22.39$15.49 to $31.62
FacilityA hospital or hospital-owned outpatient department$33.11$25.70 to $44.67

How much rates vary

Facilitymedian $33 · 10th to 90th $25 to $59Professionalmedian $22 · 10th to 90th $10 to $48
$10$20$50$100facility $33professional $22

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
$24.55
Median
$42.66
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$24.55
Typical High
$48.98
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$89.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$16.22
Typical High
$38.90
BCBS
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$37.15
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$48.98
Typical High
$112.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$23.99
Typical High
$51.29
Medica
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$39.81
Typical High
$120.23
Medica
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$27.54
United
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$25.70
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$30.90

Where Missouri 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.

Missouri· 22nd of 51

$25.70

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.