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Tumor Marker Test, Positive or Negative

North Carolina 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?

$20.42

Typical negotiated rate. In North Carolina, October 2026.

Insurers have agreed to pay about $20.42 for this service. The price depends on where it is billed: about $17.78 from a physician practice, and about $26.92 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$17.78$13.80 to $25.12
FacilityA hospital or hospital-owned outpatient department$26.92$20.42 to $54.95

How much rates vary

Facilitymedian $27 · 10th to 90th $19 to $117Professionalmedian $18 · 10th to 90th $13 to $31
$10$20$50$100facility $27professional $18

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
$20.42
Median
$20.42
Typical High
$51.29
Aetna
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$10.23
Median
$10.23
Typical High
$10.23
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$4.07
Median
$4.07
Typical High
$4.07
BCBS North Carolina
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$69.18
Typical High
$81.28
BCBS North Carolina
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$17.38
Median
$56.23
Typical High
$117.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.02
Median
$20.89
Typical High
$33.11
Medcost
Setting
Professional
Modifier
None
Typical Low
$9.55
Median
$33.88
Typical High
$47.86
Medcost
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$20.42
Typical High
$40.74
Medcost
Setting
Professional
Modifier
None
Typical Low
$16.60
Median
$27.54
Typical High
$36.31
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$13.80
Typical High
$26.92

Where North Carolina 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.

North Carolina· 37th of 51

$20.42

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.