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Tumor Marker Test, Positive or Negative

Pennsylvania 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 $39 · 10th–90th $22$950%10%20%10th90th$39Professionalmedian $21 · 10th–90th $14$390%50%10th90th$21$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$21.88
Median
$38.90
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$60.26
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$37.15
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$25.12
Typical High
$38.02
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$15.14
Typical High
$37.15
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$18.62
Typical High
$44.67
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$38.90
Typical High
$93.33
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$20.89
Typical High
$75.86
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$27.54
Typical High
$63.10
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$25.70
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$15.85
Typical High
$35.48