December 27, 2012
SUMMARY: Blood tests can cost a little or a lot–we’ve heard as low as $6 and as high as $167 for a simple complete blood count (CBC) test. The sticker price may be shockingly high — and the cash price can be surprisingly low. Hospitals tend to be more expensive than other providers. No matter where you go, lab charges can be the most expensive part of a medical experience — insurance or no. Read more, or …
Blood testing may be one of the fastest-changing sectors of the health-care marketplace, and a sector where there’s the most disruption.
Need a CBC (complete blood count) test? How much will it cost? One diagnostic center in Brooklyn charges $16, while another lab in Brooklyn bills $117 for the same lab work. (Here’s our page of results for a CBC blood test in the New York area; here’s a list of prices for a CBC blood test in the San Francisco area. Here’s Los Angeles pricing, here’s Dallas pricing and here’s Houston pricing.)
How much does a CMP (comprehensive metabolic panel) blood test cost? It can cost less than $20 or more than $100 for cash or self-pay customers. In San Francisco, the range is from $20 to $68 for cash or self-pay customers.
Here is the New York list of results for the cost of a CMP blood test; here’s the San Francisco one.
Prices can vary widely. Is the provider in network? Have you met your deductible? Are you being charged the full rate? (We also call it the “sticker price” or M.S.R.P.; others call it the “rack rate.”) Because in the health-care marketplace the sticker price is often paid only by uninsured people, it’s smart to ask; but you might also be interested to know that the “negotiated rate,” the price the insurance company pays for it can be considerably less. Here’s a blog post about a lab bill for which the charge was $401, but the negotiated rate was $24.80.
You may need a doctor-ordered prescription to get blood drawn, again depending on the state, but there are no rules about how much labs can charge for it. So, if you’re uninsured, know before you go. Also, many doctor’s offices can do some simple blood tests.
We currently list cash or self-pay prices for four fairly common tests: CBC (complete blood count), CMP (comprehensive metabolic panel), TSH (thyroid-stimulating hormone) and a cholesterol or lipids test. If you want another kind of test, you might be able to get a sense of pricing from what’s here. Also, there are many variations: CBC with differential? TSH alone or a full thyroid panel?
Online voucher options
There are also some on-line voucher options that we can’t uniformly access here in New York — as explained in this blog post, about ways to order lab tests at a discount.
The way it works: you contact the clearing-house company online, tell the test you want, pay up front, and then they send you to a participating lab. At that point, when we wrote that, the company ineedlabs.com was doing on-line vouchers, but now we see that the ineedlabs.com web site is no longer operating, and it has a referral to mdlabtests.com. (Update, Sept. 2016: Mdlabtests.com is now defunct. When we wrote about ineedlabs.com in October 2011, they had taken over prepaid lab business from prepaidlabs.com. This does not inspire confidence; if you have experience with them, please write us at info (at) clearhealthcosts (dot) com.)
State regulations may apply for availability: an update on the mdalabtests.com site says “MDLabTests.com is now available in New York, New Jersey, Massachusetts & Rhode Island for Wellness & STD Testing ONLY (part of a limited usage pilot program). Maryland is still unavailable for the time being.”
If I was thinking about using an online voucher option, I’d be careful to do my homework first.
Big changes on the horizon
On the horizon, we see big changes — right now especially from a new lab testing service that is quick, painless, inexpensive and more accurate than the current systems, according to a report in The Wall Street Journal.
It’s called Theranos, and it was founded by a Stanford dropout named Elizabeth Holmes. Right now they are doing these tests at the Walgreen’s in Palo Alto, Calif., and they plan to expand beyond that. They’re publishing retail prices on their website, and their prices are a fraction of what we found in our San Francisco survey. Look out, Labcorp and Quest.
“Theranos is committing to a half-off discount on Medicare fees. ‘So a test that costs $100 now, we’ll do $50 or less. The quote-unquote payer community I don’t think has ever seen someone walk in and say we want to bill you at less than you’re willing to reimburse,’ she says. If this strategy succeeds in squeezing down prices—say, lowering testing as a share of total health costs to 1.5% from 2.3% now—it could save Medicare $61 billion over 10 years and Medicaid $96.1 billion, according to what Theranos calls a conservative estimate.”
(Update, February 2016: Theranos has encountered a series of challenges and setbacks to its technology and business model; here’s a New York Times article.)
The takeaway: Things you should know
- For both insured and uninsured people, it’s important to ask before you go — what is this blood test going to cost me?
- Inquire about available discounts. At one Brooklyn-based laboratory chain, uninsured customers qualify for a 50%-off coupon upon request — but you have to ask for the coupon, we were told during our survey. Another lab charges uninsured patients nearly 70% less than clients with insurance.
- One laboratory in Connecticut told us they bills uninsured patients based on the test and the client’s circumstances, offering income-based discounts. But one of the big things we learned is that if you ask for a cash or self-pay rate, you can find low prices.
- There are many variations: CBC with differential? TSH alone or a full thyroid panel? Ask.
- How will you get results? Will they be sent directly to your doctor? Do you want to see the results yourself? Ask up front.
- Ask if there are any extra costs: some places charge a “draw fee” or a “venipuncture fee.” If you are having four tests, even if it’s only one needle, you might get charged four times. Ask. “Are there any other fees or charges?”
- Accreditation is good. Two organizations that accredit labs: College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA).