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Tumor Marker Test, Positive or Negative

New Hampshire 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?

$27.54

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $27.54 for this service. The price depends on where it is billed: about $22.39 from a physician practice, and about $70.79 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 5 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$16.60 to $42.66
FacilityA hospital or hospital-owned outpatient department$70.79$47.86 to $105

How much rates vary

Facilitymedian $71 · 10th to 90th $35 to $148Professionalmedian $22 · 10th to 90th $15 to $58
$10$20$50$100facility $71professional $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
$35.48
Median
$70.79
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$22.39
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$48.98
Typical High
$144.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$16.60
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$97.72
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$22.91
Typical High
$74.13
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$44.67
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$16.60
Typical High
$57.54

Where New Hampshire 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.

New Hampshire· 15th of 51

$27.54

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.