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Tumor Marker Test, Positive or Negative

West Virginia 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?

$20.89

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $20.89 for this service. The price depends on where it is billed: about $15.49 from a physician practice, and about $50.12 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$15.49$11.48 to $38.02
FacilityA hospital or hospital-owned outpatient department$50.12$25.12 to $63.10

How much rates vary

Facilitymedian $50 · 10th to 90th $21 to $76Professionalmedian $15 · 10th to 90th $11 to $54
$10$20$50$100facility $50professional $15

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$20.42
Median
$20.89
Typical High
$20.89
CareSource
Setting
Facility
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
CareSource
Setting
Professional
Modifier
None
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Cigna
Setting
Facility
Modifier
None
Typical Low
$25.12
Median
$50.12
Typical High
$75.86
Cigna
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$36.31
Typical High
$123.03
United
Setting
Facility
Modifier
None
Typical Low
$15.49
Median
$15.49
Typical High
$15.49
United
Setting
Professional
Modifier
None
Typical Low
$10.23
Median
$12.88
Typical High
$53.70

Where West Virginia 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.

West Virginia· 31st of 51

$20.89

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.