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Tumor Marker Test, Positive or Negative

Montana 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?

$38.02

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $38.02 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $43.65 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$25.70$11.22 to $34.67
FacilityA hospital or hospital-owned outpatient department$43.65$38.02 to $47.86

How much rates vary

Facilitymedian $44 · 10th to 90th $35 to $55Professionalmedian $26 · 10th to 90th $11 to $46
$10$20$50$100facility $44professional $26

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
Professional
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$29.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$50.12
Typical High
$144.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$13.49
Median
$29.51
Typical High
$36.31
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$31.62
Median
$43.65
Typical High
$51.29
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$38.02
Typical High
$46.77
Providence
Setting
Facility
Modifier
None
Typical Low
$28.18
Median
$50.12
Typical High
$144.54
Providence
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$25.70
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$25.70

Where Montana 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.

Montana· 4th of 51

$38.02

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.