With Health Insurance: Copays of $0-$30 or 10%-50+% Coinsurance
Total Costs: $100-$3,000+ Without Insurance
Blood tests can measure cells, lipids, proteins, sugars, hormones, tumor markers and other blood components. They are used to diagnose and treat of many diseases including diabetes, high cholesterol, thyroid disease and cancer.
Typical costs:
CostHelper readers with insurance report out-of-pocket costs of $283-$675 for blood tests, with an average of $432; total billed costs were $312-$1,200 (averaging $755), with the insurance either paying or discounting the total cost by $29-$525.
For patients covered by health insurance, out-of-pocket costs for blood work typically consist of a copay ranging from nothing to $30 or more, or coinsurance of 10%-50% or more; deductibles and out-of-pocket maximums will apply.
Blood tests are often covered by health insurance for preventive, diagnostic or treatment purposes, but coverage depends on the individual case and the terms of the health insurance plan.
CostHelper readers without health insurance report total costs of $700-$2,589, averaging $1,543. For patients not covered by health insurance, total costs can be $100-$3,000 or more, depending on the number and type of tests ordered; the cost of any doctor visits to order and interpret the tests; and whether the tests are done on an emergency basis.
Routine blood work done as part of an annual physical or a new patient exam can cost $100-$1,000 or more. Often ordered in connection with an annual physical, a complete blood count (CBC) test alone can cost $10-$150 or more.
Depending on the patient's symptoms, doctors typically order multiple tests to check for a number of conditions; comprehensive panels of tests can cost $80-$1,500 or more, and combining several testing packages can bring total costs to $1,500-$2,700 or more.
Before any blood test, the patient typically will be given instructions to follow, such as fasting for a certain number of hours. The medical provider then draws blood and sends it to a laboratory for analysis. Results usually are provided to the patient and/or their doctor within a few days to a week.
The National Institutes of Health lists types of common blood tests[1] .
Additional costs:
Depending on the results, the doctor may recommend additional testing.
Discounts:
The U.S. Department of Health and Human Services offers a locator [2] for clinics providing services on an income-based sliding scale.
Many hospitals offer discounts of up to 50% for uninsured/self-paying patients. For example, St. Joseph Hospital[3] in Orange, CA discounts its billed charges by 45%.
Shopping for blood tests:
Patients with health insurance that requires them to use "in network" providers should check whether a specific lab is within the network; a doctor who works within an insurance plan might, without checking, refer patients to a lab that isn't covered under that plan. Always double-check for insurance coverage before any blood work is done.
Blood tests can be done at the office of a primary care provider or specialist, in a clinic or in a hospital.
For patients who want anonymity or do not wish to go through a doctor, companies such as LabCorp[4] , Quest Diagnostics[5] and Health Testing Centers[6] offer laboratory testing direct to patients. However, it is important to seek the advice of a doctor for any health concerns.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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Another useful tool - https://www.dhcs.ca.gov/provgovpart/Pages/DRG-Pricing-Resources-for-SFY-2021-22.aspx This is the pricing calculator for getting the Medicaid California reimbursement rate for the ENTIRE COST of inpatient admissions. Medicare and Medicaid have in most states implemented pricing scheme based on the "DRG", which is a code for reason patient was admitted, rather than paying for each service because hospitals of rampant over billing. Basically, you take the primary reason for the admission, use the national average for days people stay in the hospital for that reason, take into consideration some extenuating circumstances, and thats the TOTAL AMOUNT hospitals should get paid for a specific admit. The overall cost to charge ratio is also telling - hospitals usually bill 4-5 times what they actually expect to receive in a negotiated rate situation.
I started working at a medicare advantage a couple of years ago, and our contracted rate for most blood tests are $5-10 a piece. If you want to get an idea of how much insurers pay - look up the CPT code for your test, and check them against how much medicaid in California pays : https://files.medi-cal.ca.gov/rates/rates_download.aspx Medicare rates are a bit more difficult to calculate because it has a complicated set of factors and regional adjustments, but a good rule of thumb is to take highest base medicaid rate for your procedure, multiply it by 2 (it's usually much less than that), and no insurer will pay a negotiated rate higher than that. $0 rates are non-covered procedures, or considered incidental to other care. Hope this helps.
I have learned for any Medicare work to be careful: The patient authorization/sign up sheet typically has a phrase that if Medicare doesn't cover a cost, I will pay for it. I scratch this out and write that I decline and do not authorize any tests, treatments or other expenditures not covered by Medicare. I cannot afford them. I do not understand what is and is not covered. That is the responsibility of those offering the service to determine in advance. I now do this on every Medicare service. So far, no one has turned me down. I also request a copy of the document. In 2017 I received a bill from Labcorp for about $500 in blood work not covered by Medicare. I referred to my written document showing this was an unauthorized service, that I did not have the means to pay for it, and I was refusing to. After a few phone calls they admitted it was their mistake and cancelled the charges. I would rather find someone willing to do this than get caught with bills I can't pay.
they told us that the bill for the ER visit was only $210. later on we receive a bill for $1000. i got around 4-6 blood tests. all im mad about is that they lied to us.
I have medicare and supplemental insurance. I am being charged $299 for 4 blood tests that medicare did not cover. I don't know if my doctor screwed up on requesting the tests. This is total BS. Pay for medicare insurance & supplemental insurance and still get a bill. Why $299 for 4 blood tests with insurance?
Patient went where he was directed to go and his out of pocket was marked up about 80 to 90% in my experience as a Phlebotomist working with various Labs
Type of Blood Test: Have yet to disclose that information me
Got a bill with no information about tests or cost of each, how many, what kind, information at the hospital was withheld until I got my bill... $6,187.97
My insurance carrier initially refused payment due to a clerical error on their part. The bill from labcorp rolled in at $980. Months later and weeks from going to collections, insurance company corrected error and reprocessed, and amount reduced to $180 per negotiated discount with carrier. I got curious and have researched this issue extensively and have learned that both Labcorp and Quest offer a 45% discount for uninsured, but that you have to work with your doctor and the lab to get the discount. I also checked with multiple online web labs and have uncovered that discounts for the same tests from retail range from as little as 25% to a high of 43%. The marketing is sleek, but the pricing model is straight forward. The labs themselves are milking the uninsured by greater than 230% from those who know how to negotiate this mine field and the on-line labs are simply marking up a few points over the lab providers' uninsured discount. As for those who don't know, the markup is 540%
Why is blood lab work so freaking expensive? During one visit with Doc, my EOB from Ins. Company showed Doc Blood full CBC @ 900., Hospital Lab @ 4,918. Really? Three viles with Doc at one visit. What does it mean, Doc looked at one and sent two to Hospital? Who controls these outrageous fees? Thank God we have Insurance; billed 333. How do they get away billing it? God Bless America!
The Dept of Veterans' Affairs has various clinics that provide comprehensive care and blood tests for veterans. Mine is at Ft Belvoir, VA, and they do all tests for me at no cost. I then take test results to my civilian doctor.
I have had well over 50 blood tests since Kidney Transplant, each costing around $125 or less., $40 out of pocket after Insurance. UVA charged me $4,780 for exact same testing, and my out of pocket is $820 ! OUTRAGEOUS, NOT paying, and contacting State Attorney General
Went to the ER for pelvic pain. I was billed: $92.82 for a liter of normal saline (IVF) $732.12 for a CMP $101.20 for a urinalysis $250.47 for a CBC $169.20 for a PT $616.31 for "IV HYD INT >31M" $350.66 for a lipase $866.52 for "ABD ACUTE COMP" and a whopping $2123.62 "for ER visit level IV" ... I was only in the ER for 2 hours, the "doctor" examined me THROUGH MY CLOTHES(!), and then separately billed me over $500.00 for that "exam". Thoroughly criminal, in my opinion.
In October, a full workup cost me $30 out of pocket. I just got a basic workup in Jan. after being put on blood meds and it cost me $187. Why so much for a more basic test?
My dr started using the facility for lab work. I have never been charged this much before, and can't afford to pay it, haven't worked since October. The hospital told me they actually out source it to someone else in another state, I called them to get a explanation but nobody answers.
Simple CBC was ordered for unknown reasons by my pain mgmt dr. Won't send to my in network Labcorp - and charged a whopping $7939.32. Insurance wouldn't pay bc out of network. Now sending me the bill for a reduced $329.87! Um NO. I have a zero copay and excellent insurance. This is such a ripoff and I'm shutting them down.
My insurance company was billed $3,220 for this test. They paid $643.80. This was not for a group of tests. The amount charged is outrageous. I don't think the hospital or doctors see or are aware of these excessive amounts. I feel the patient must stand up for the insurance company in these circumstances. The testing company is NeoGenomics Labs in Orlando, FL
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