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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.

Facilitymedian $32 · 10th–90th $20$650%10%20%10th90th$32Professionalmedian $20 · 10th–90th $10$320%10%20%10th90th$20$10.0$20.0$50.0$100.0

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
$20.42
Median
$35.48
Typical High
$64.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$20.42
Typical High
$33.11
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
$16.60
Typical High
$87.10
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$18.20
Typical High
$34.67
Molina
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$23.99
Typical High
$31.62
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$26.92
Typical High
$52.48
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
$14.13
Typical High
$27.54