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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 October 2026.

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

$21.88

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $21.88 for this service. The price depends on where it is billed: about $20.89 from a physician practice, and about $32.36 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$20.89$15.49 to $21.88
FacilityA hospital or hospital-owned outpatient department$32.36$25.70 to $74.13

How much rates vary

Facilitymedian $32 · 10th to 90th $21 to $91Professionalmedian $21 · 10th to 90th $11 to $32
$10$100$1Kfacility $32professional $21

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
$20.89
Median
$21.88
Typical High
$74.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$18.62
Median
$20.89
Typical High
$21.88
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$10.00
Median
$10.47
Typical High
$10.96
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.98
Median
$4.17
Typical High
$4.37
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$91.20
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$21.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$17.78
Median
$37.15
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$23.99
Typical High
$39.81
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$12.02
Typical High
$37.15
Geisinger
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Geisinger
Setting
Professional
Modifier
None
Typical Low
$12.88
Median
$18.20
Typical High
$38.02
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$20.89
Median
$20.89
Typical High
$87.10
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$20.89
Typical High
$21.88
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$10.47
Median
$10.47
Typical High
$10.96
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$4.17
Median
$4.17
Typical High
$4.37
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$28.18
Median
$29.51
Typical High
$63.10
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$17.38
Median
$17.38
Typical High
$17.38
United
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$25.70
Typical High
$30.90
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$16.22
Typical High
$36.31

Where Pennsylvania 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.

Pennsylvania· 28th of 51

$21.88

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.