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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 October 2026.

How much does Tumor Marker Test, Positive or Negative cost?

$30.20

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $30.20 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $97.72 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$19.05$11.75 to $30.90
FacilityA hospital or hospital-owned outpatient department$97.72$33.88 to $155

How much rates vary

Facilitymedian $98 · 10th to 90th $19 to $204Professionalmedian $19 · 10th to 90th $11 to $43
$10$20$50$100$200facility $98professional $19

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
$19.05
Median
$81.28
Typical High
$85.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.05
Median
$30.90
Typical High
$30.90
BCBS
Setting
Facility
Modifier
None
Typical Low
$38.02
Median
$138.04
Typical High
$213.80
Cigna
Setting
Facility
Modifier
None
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$35.48
Typical High
$48.98
Providence
Setting
Facility
Modifier
None
Typical Low
$16.22
Median
$26.92
Typical High
$33.88
Providence
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$35.48
Typical High
$48.98
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
$11.48
Typical High
$15.49

Where New Mexico 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 Mexico· 11th of 51

$30.20

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.