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Tumor Marker Test, Positive or Negative

Ohio 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?

$21.38

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $21.38 for this service. The price depends on where it is billed: about $18.62 from a physician practice, and about $33.11 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 8 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$18.62$12.59 to $23.99
FacilityA hospital or hospital-owned outpatient department$33.11$25.70 to $56.23

How much rates vary

Facilitymedian $33 · 10th to 90th $20 to $83Professionalmedian $19 · 10th to 90th $10 to $46
$10$20$50$100facility $33professional $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
$20.89
Median
$43.65
Typical High
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$21.38
Typical High
$83.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$26.92
Typical High
$46.77
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$13.18
Typical High
$18.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$29.51
CareSource
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$33.11
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$19.95
Typical High
$38.02
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$33.88
Typical High
$104.71
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$19.50
Typical High
$37.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$23.99
Typical High
$31.62
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$26.92
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$25.70
Typical High
$38.02
United
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.59
Typical High
$27.54

Where Ohio 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.

Ohio· 36th of 51

$21.38

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.