Tumor Marker Blood Test, Other Antigen

Delaware rates for HCPCS 86316

This blood test measures the level of a specific protein marker that can be elevated with certain types of cancer, using a technique that gives a precise numerical result rather than a simple positive or negative. It is used for markers that fall outside the handful of the most common, individually named tumor marker tests. Results are typically tracked over time to help monitor how a cancer is responding to treatment or to watch for signs of it returning.

Rates data updated July 2026.

How much does Tumor Marker Blood Test, Other Antigen cost?

$23.99

Typical negotiated rate. In Delaware, July 2026.

Insurers have agreed to pay about $23.99 for this service. The price depends on where it is billed: about $17.38 from a physician practice, and about $200 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 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$17.38	$16.60 to $63.10
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$200	$21.88 to $324

How much rates vary

Facilitymedian $200 · 10th to 90th $17 to $372Professionalmedian $17 · 10th to 90th $17 to $63

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $17.38 Median $199.53 Typical High $371.54	Facility	Global	$17.38	$199.53	$371.54
Aetna Setting Professional Modifier Global Typical Low $16.60 Median $17.38 Typical High $63.10	Professional	Global	$16.60	$17.38	$63.10
Cigna Setting Facility Modifier Global Typical Low $13.49 Median $13.49 Typical High $13.49	Facility	Global	$13.49	$13.49	$13.49
Cigna Setting Professional Modifier Global Typical Low $12.88 Median $14.79 Typical High $38.90	Professional	Global	$12.88	$14.79	$38.90
Highmark BCBS Setting Facility Modifier Global Typical Low $20.89 Median $20.89 Typical High $54.95	Facility	Global	$20.89	$20.89	$54.95
United Setting Professional Modifier Global Typical Low $10.23 Median $14.79 Typical High $28.84	Professional	Global	$10.23	$14.79	$28.84

Where Delaware sits

The same service costs 3.1 times more in Pennsylvania than in Tennessee. 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.

Delaware· 32nd of 51

$23.99

PA $51.29TN $16.60

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.