go back

Tumor Marker Test, Positive or Negative

New York 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.

Facilitymedian $38 · 10th–90th $18$710%10%20%10th90th$38Professionalmedian $16 · 10th–90th $10$400%20%40%10th90th$16$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$42.66
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$17.78
Typical High
$25.70
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$13.18
Typical High
$45.71
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$25.70
Typical High
$25.70
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$25.70
Typical High
$25.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$54.95
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$33.88
Typical High
$123.03
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$10.00
Median
$25.70
Typical High
$57.54
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$15.49
Typical High
$50.12
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$13.49
Typical High
$26.92
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$45.71
Typical High
$257.04
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$27.54
Typical High
$52.48
United
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$27.54
Typical High
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.85
Typical High
$57.54
Univera
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$9.77
Typical High
$29.51
Univera
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$21.88
Typical High
$53.70