How Much Does Immunologic Analysis for Detection of Tumor Antigen, Quantitative; Ca 125 Cost?
Also known as: Immunologic analysis for detection of tumor antigen, quantitative; CA 125 (CPT 86304)
A CA-125 blood test used primarily to monitor ovarian cancer treatment response.
Immunologic Analysis for Detection of Tumor Antigen, Quantitative; Ca 125 (CPT 86304) costs $21 at Medicare rates.
The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.
Patient Guide: Immunologic Analysis for Detection of Tumor Antigen, Quantitative; Ca 125
What you need to know before your appointment
What to Expect
A blood sample is drawn from your arm. CA-125 is a protein that can be elevated in ovarian cancer.
How Long Does It Take?
5-10 minutes
Common Reasons Doctors Order This
Ovarian cancer monitoring, pelvic mass evaluation, treatment response monitoring
How to Prepare
No fasting or special preparation. Menstruation and some benign conditions can cause mild elevations.
Procedures Commonly Done Together
These procedures are frequently performed alongside Immunologic analysis for detection of tumor antigen, quantitative; CA 125
How to Reduce Your Cost for Immunologic analysis for detection of tumor antigen, quantitative; CA 125
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Immunologic analysis for detection of tumor antigen, quantitative; CA 125 cost?
The Medicare facility rate for Immunologic analysis for detection of tumor antigen, quantitative; CA 125 is $21. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Immunologic analysis for detection of tumor antigen, quantitative; CA 125 cost without insurance?
Without insurance, the cost of Immunologic analysis for detection of tumor antigen, quantitative; CA 125 can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Immunologic analysis for detection of tumor antigen, quantitative; CA 125?
Most commercial health insurance plans and Medicare cover Immunologic analysis for detection of tumor antigen, quantitative; CA 125 when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.