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Tumor Marker Test, Positive or Negative

South Dakota 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?

$48.98

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $42.66 from a physician practice, and about $48.98 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 6 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$42.66$23.99 to $61.66
FacilityA hospital or hospital-owned outpatient department$48.98$48.98 to $48.98

How much rates vary

Facilitymedian $49 · 10th to 90th $29 to $49Professionalmedian $43 · 10th to 90th $17 to $66
$10$20$50$100facility $49professional $43

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
$17.78
Typical High
$17.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$19.95
Typical High
$23.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$48.98
Typical High
$61.66
Medica
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$30.20
Typical High
$77.62
Medica
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$13.80
Typical High
$30.90
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$53.70
Typical High
$70.79
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$22.91
Typical High
$30.90
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70

Where South Dakota 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 Dakota· 1st of 51

$48.98

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.