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Tumor Marker Test, Positive or Negative

Vermont 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?

$33.88

Typical negotiated rate. In Vermont, July 2026.

Insurers have agreed to pay about $33.88 for this service. The price depends on where it is billed: about $33.88 from a physician practice, and about $151 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$33.88$33.88 to $33.88
FacilityA hospital or hospital-owned outpatient department$151$25.70 to $331

How much rates vary

Facilitymedian $151 · 10th to 90th $9 to $347Professionalmedian $34 · 10th to 90th $17 to $34
$10$20$50$100$200facility $151professional $34

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$30.20
Typical High
$36.31
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
United
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$8.91
Typical High
$8.91
United
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$27.54
Typical High
$56.23

Where Vermont 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.

Vermont· 5th of 51

$33.88

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.