Immunoassay for tumor antigen, quantitative; CA125
| 2020 CPT/HCPCS Primary Code | 86304 |
| Negotiated Private Fee | $28.00 |
| Prossam | $43.00 |
| Champva | $20.81 |
| First Medical | $39.00 |
| First Medical Vital | $19.19 |
| Plan de Salud Menonita | $17.00 |
| Menonita Vital | $19.19 |
| Humana Gold plus/ Gold choice | $20.81 |
| Humana | $45.00 |
| Mapfre | $65.00 |
| Mcs Classicare | $20.81 |
| MCS Life | $27.42 |
| Medicare | $20.81 |
| MMM | $28.51 |
| MMM Vital | $17.99 |
| Panamerican Life | $60.00 |
| PMC | $28.51 |
| Tricare | $20.81 |
| Triple S Salud | $39.83 |
| Triple S Vital | $29.94 |
| Triple S Advantage | $51.40 |
| Negotiated Minimum Charge | $17.00 |
| Negotiated Maximus Charge | $65.00 |
| Discounted Cash Price | $22.40 |
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