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Tumor Marker Test, Positive or Negative

South Carolina 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?

$20.42

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $20.42 for this service. The price depends on where it is billed: about $19.95 from a physician practice, and about $63.10 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 5 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$19.95$19.95 to $22.39
FacilityA hospital or hospital-owned outpatient department$63.10$30.20 to $81.28

How much rates vary

Facilitymedian $63 · 10th to 90th $20 to $110Professionalmedian $20 · 10th to 90th $20 to $27
$10$20$50$100facility $63professional $20

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
$17.78
Median
$63.10
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$22.39
BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$66.07
Typical High
$107.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$27.54
Typical High
$43.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$75.86
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$13.49
Typical High
$30.90
Medcost
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$26.30
Typical High
$45.71
United
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$25.70
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.49
Typical High
$30.90

Where South Carolina 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.

South Carolina· 44th of 51

$20.42

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.