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Tumor Marker Test, Positive or Negative

Tennessee 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?

$19.95

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $19.95 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $38.90 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$19.05$19.05 to $20.42
FacilityA hospital or hospital-owned outpatient department$38.90$21.88 to $85.11

How much rates vary

Facilitymedian $39 · 10th to 90th $17 to $91Professionalmedian $19 · 10th to 90th $17 to $26
$10$20$50$100$200facility $39professional $19

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
$19.05
Median
$38.90
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$24.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$25.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$16.98
Median
$53.70
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$16.60
Typical High
$36.31
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$23.99
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.85
Typical High
$27.54

Where Tennessee 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.

Tennessee· 46th of 51

$19.95

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.