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Tumor Marker Test, Positive or Negative

New Jersey 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?

$17.78

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $17.78 for this service. The price depends on where it is billed: about $16.22 from a physician practice, and about $56.23 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$16.22$12.59 to $17.78
FacilityA hospital or hospital-owned outpatient department$56.23$25.70 to $87.10

How much rates vary

Facilitymedian $56 · 10th to 90th $17 to $151Professionalmedian $16 · 10th to 90th $13 to $25
$10$20$50$100$200facility $56professional $16

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
$12.59
Median
$14.79
Typical High
$31.62
Aetna
Setting
Professional
Modifier
None
Typical Low
$12.59
Median
$12.59
Typical High
$23.44
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$6.31
Median
$6.31
Typical High
$11.75
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.51
Median
$2.51
Typical High
$4.68
Cigna
Setting
Facility
Modifier
None
Typical Low
$22.39
Median
$56.23
Typical High
$125.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$26.92
Typical High
$54.95
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$12.88
Typical High
$15.14
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$23.44
Median
$151.36
Typical High
$204.17
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
United
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$22.91
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$15.49
Typical High
$25.70

Where New Jersey 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.

New Jersey· 46th of 51

$17.78

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.