go back

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 July 2026.

How much does Tumor Marker Test, Positive or Negative cost?

$24.55

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $24.55 for this service. The price depends on where it is billed: about $22.39 from a physician practice, and about $120 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$22.39$19.50 to $25.12
FacilityA hospital or hospital-owned outpatient department$120$29.51 to $135

How much rates vary

Facilitymedian $120 · 10th to 90th $25 to $174Professionalmedian $22 · 10th to 90th $19 to $30
$10$20$50$100facility $120professional $22

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
$25.12
Median
$134.90
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$23.99
Typical High
$29.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$26.92
Typical High
$70.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$19.50
Typical High
$38.02
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$104.71
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$21.88
Typical High
$22.91
Select Health
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$17.78
Typical High
$17.78
Select Health
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$25.70
Typical High
$33.11
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$22.39
Typical High
$38.02
United
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$16.60
United
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$11.48
Typical High
$27.54

Where Utah 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.

Utah· 29th of 51

$24.55

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.