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Tumor Marker Test, Positive or Negative

Rhode Island 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?

$23.44

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $23.44 for this service. The price depends on where it is billed: about $16.22 from a physician practice, and about $46.77 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 4 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$16.22$16.22 to $21.88
FacilityA hospital or hospital-owned outpatient department$46.77$30.20 to $100

How much rates vary

Facilitymedian $47 · 10th to 90th $21 to $102Professionalmedian $16 · 10th to 90th $14 to $35
$10$20$50$100facility $47professional $16

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
$25.70
Median
$63.10
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$46.77
BCBS
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$29.51
Typical High
$31.62
BCBS
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$19.05
Typical High
$29.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$46.77
Typical High
$83.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$21.88
Typical High
$36.31
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$25.70
Typical High
$33.88

Where Rhode Island 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.

Rhode Island· 31st of 51

$23.44

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.