I hear a lot of complaint about lab tests costs, with and without insurance.
Well, finally, some labs are being more transparent with those costs.
Now you can actually compare them, and we did.
Arizonans can now order tests without having a doctor involved.
So we looked at 6 common blood tests:
- Basic Metabolic Panel (BMP)
- Comprehensive Metabolic Panel (CMP)
- Complete Blood Count (CBC) w/differential
- Hepatic Function Panel/Liver
- Lipid Panel
- Thyroid Stimulating Hormone (TSH)
We compared prices at 4 different labs. Here are the results from the first 3 labs for individual ordered tests without insurance involved:
THERANOS:
BMP $5.76
CMP-$7.19
CBC-$5.29
Hepatic/Liver $5.62
Lipid-$9.11
TSH-$11.44
6 test average: $7.40
ANY LAB TEST NOW:
Each compared test-$49
6 test average: $49
SONORA QUEST
BMP-$14
CMP-$17
CBC-$11
Hepatic/Liver-$13
Lipid 21
TSH-$26
6 test average: $17
LabCorp provided us a list of 20 tests they allow individuals to order without a doctor. Only one of them was on our comparison list. It was the TSH test and LabCorp charges $43.
So we asked Hospital Pricing Specialists to help. The business gathers data on lab costs billed to Medicare.
While it's not an apples to apples comparison, here's what they found:
LABCORP (Source: Hospital Pricing Specialists)
BMP-$44.42
CMP-$49.30
CBC-$40.52
Hepatic/Liver $43.12
Lipid-$89.93
TSH- $103.63
6 test average: $61.82 *billed to Medicare*
The LabCorp prices are what is billed to Medicare, not what Medicare may end up paying.
LabCorp says: "It would be inaccurate to state that the prices you note represent LabCorp’s charges for those tests, except for the specific third-party payment program(s) for which that information was obtained. Medicare fees are established by CMS (Centers for Medicare and Medicaid Services) and not by the laboratory. As we previously discussed, test pricing is dependent on many factors including the applicable third-party insurance plan. Patients should check with their insurance company for more information about prices specific to their plan."
LabCorp says you can find its list of available individual ordered tests through LabCorp’s Direct Access Testing program
Concerning different prices for lab tests when insurance is involved, Sonora Quest says
"There are different prices/costs that a consumer may pay for many reasons. All of these mirror the experience on the medical side of the healthcare equation:
As healthcare costs continue to climb, many employers and plans are implementing high deductible plans. In those cases, a consumer may pay 100% of the expect price until such time as the deductible is met. At that time, the cost would change to the negotiated copay or coinsurance, or, if the test isn’t a covered benefit, they may still pay 100%, even after the deductible is met.
If a test isn’t covered by insurance this year, but was last year, the consumer may see a change in the amount that is owed at the time of service.
Insurance plans provide varied coverage, deductibles and co-pays. As a result, consumers covered through different plans may pay different amounts.
If a test is purchased through MyLabRequest via Direct Access Testing, the insurance company is, by law, not required to cover the service. So, a consumer may pay a different cost depending on if they are requesting testing ordered by their provider and submitting via their insurance or if they are ordering the test themselves and paying for it themselves."
You can find Sonora Quest prices for individual tests here.
AnyLabTestNowsays "“In order to be completely transparent with the pricing for all of our 6000+ clinical tests, we are self-pay. However, customers can use FSA or HSA cards."
Theranos says they have just one price whether you use insurance or not.
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