Many people inquire about the approximate cost of the lab tests. The short answer is that it varies depending on your specific condition and insurance coverage. Some laboratory companies will accept insurance with a reduced insurance copayment and file on your behalf while other labs require full payment upfront and will provide a receipt that can be turned into your insurance company for reimbursement on your own. In functional medicine we want to “test not guess” what is happening in the body. This is why testing is especially needed at your initial evaluation. The types of test include both conventional lab test from companies you might be familiar with like Lab Corp and Quest as well as many other specific functional lab tests through companies that specialize in functional medicine (i.e. Genova, SpectraCell, Doctor’s Data, Great Plains Laboratory, etc.). The average patient will spend between $1000-$2000 worth of initial testing. This will vary depending on your insurance coverage and severity of your case.

LabCorp and Quest Labs offers 2 options

1. Insurance file – you can generally use your medical insurance and have Quest labs file this directly with your insurance company. We will not assume any responsibility for denial of payment by your insurance company and our office will not engage in any dialog with the insurance company or lab over denial of payment. It is solely your responsibility to confirm with your insurance company if tests will be covered under your policy before having them drawn. Insurance carriers may also deem certain labs unjustified or unnecessary and not cover the cost of these labs. We order labs that we feel are necessary for your care and treatment and what we feel are needed to move you forward on your own personal health journey. Your insurance company may not feel the same and deny coverage for some tests. It is impossible for us to determine this upfront.

2. “Client pay” – If you are uninsured, have a high deductible health plan, do not want your labs run through your insurance company or simply want to know the exact cost of the labs before having them drawn then you can choose to pay our practice for the labs at a discounted practice “client” rate that our practice receives. In this scenario, we will provide you with an estimate of the labs price which can be paid directly to our practice at a discounted rate. You cannot submit this to your insurance company for reimbursement after the fact since you are already getting discounted cash pay prices. The advantage of this is that you will know the exact cost of the labs upfront and will not get any surprise bills from your insurance company for tests that they deemed “unnecessary” or “not covered”

Functional lab company – prices vary by the lab. All of them offer a cash pay option, some have some insurance coverage, while other require an insurance copay be submitted. Some labs provide our office practice a discounted “client pay” option that we can pass on to our patients and is billed to our practice. This price varies by each lab test and will be provided when tests are recommended.

If you would like further information or would like to make a free 15 minute Discovery Appointment, please click here.