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Tumor Marker Test, Positive or Negative

Utah 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?

$25.12

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $25.12 for this service. The price depends on where it is billed: about $21.88 from a physician practice, and about $29.51 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$21.88$15.49 to $25.12
FacilityA hospital or hospital-owned outpatient department$29.51$25.12 to $135

How much rates vary

Facilitymedian $30 · 10th to 90th $25 to $174Professionalmedian $22 · 10th to 90th $11 to $30
$10$20$50$100facility $30professional $22

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
$25.12
Median
$134.90
Typical High
$173.78
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$12.30
Median
$67.61
Typical High
$87.10
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$5.01
Median
$26.92
Typical High
$34.67
Aetna
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$25.12
Typical High
$25.70
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$8.51
Median
$12.30
Typical High
$12.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$3.39
Median
$5.01
Typical High
$5.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$22.39
Median
$27.54
Typical High
$72.44
Cigna
Setting
Professional
Modifier
None
Typical Low
$12.30
Median
$20.89
Typical High
$36.31
Molina
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$35.48
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$29.51
Typical High
$104.71
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$17.38
Median
$19.50
Typical High
$22.91
Select Health
Setting
Facility
Modifier
None
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
Select Health
Setting
Professional
Modifier
None
Typical Low
$17.78
Median
$25.70
Typical High
$33.11
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$25.70
Typical High
$54.95
United
Setting
Professional
Modifier
None
Typical Low
$10.72
Median
$11.48
Typical High
$15.49

Where Utah 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.

Utah· 23rd of 51

$25.12

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.