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Tumor Marker Test, Positive or Negative

New Mexico 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?

$30.90

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $30.90 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $81.28 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$19.05$19.05 to $30.90
FacilityA hospital or hospital-owned outpatient department$81.28$38.02 to $158

How much rates vary

Facilitymedian $81 · 10th to 90th $23 to $214Professionalmedian $19 · 10th to 90th $12 to $170
$10$100$1K$10K$100Kfacility $81professional $19

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
$38.02
Median
$75.86
Typical High
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$30.90
Typical High
$169.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$141.25
Typical High
$229.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$30.20
Typical High
$42.66
Providence
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$25.12
Typical High
$30.90
Providence
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$30.20
Typical High
$42.66
United
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$22.91
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$11.48
Typical High
$19.05

Where New Mexico 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 Mexico· 8th of 51

$30.90

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.