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Does anyone have a approximate cost for lab work that someone like Dr T would order? I have put off having labs done because we have a 6,000 deductible, but I think I am going to have to break down and get a phone consult and labs. I just wanted to know a round about figure that I am going to have to save first. Also, do different labs charge more than others?

 

Melanie

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I have a $2400 deductible. I don't think the labs Dr T wrote for cost more than $200. Our insurance is BCBS PPO. If I used an approved provider, the provider was limited to charge me the negotiated rate of my insurer. It was a LOT less then their normal charges. Quest and LabCorp are probably approved providers for most insurance companies. You can call them and inquire.

 

My insurer also counted Dr T's fees toward my deductible.

Edited by nicklemama
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We just had a lab appointment yesterday at Labcorp to get new baseline numbers for the kids, and they seem to have a new policy of informing you in advance what the total costs would be if your insurer doesn't cover it (not sure if this is a new nat'l policy or just around here b/c of a recent issue about this that has been in the local media). If not covered, the total cost would have been about $2,200-$2,700 (ds had more tests drawn than dd). But, pretty sure that was without the insurance discount.

 

Anyway, yesterday our kids were drawn for:

Quantitative Immunoglobulins, A, E, G, M

IgG Subclasses 1-4

S.Pneumoniae titers- 14 serotype

Haemophilus Influenzae IgG

MycoP IgG and IgM

H. Plyori IgG, IgM, IgA

Anti-DNase B

ASO

CBC w/ Diff Platelet

Comp Metabolic Panel

GGT

Sedimentation Rate- Westergren

Urinalysis

 

I know I'm missing one or two because the total doesn't match what was entered at the lab yesterday, but I don't have the lab orders anymore. My dd had 14 in her original order + 2 they wrote in a couple after the fact. Ds had 14 or 15, plus four additional written in for allergy issues. It may have been C Reactive Protein and a Thyroid Panel, since that's been included in most other sets of labs they've had run.

 

In addition, they've had Lyme testing, Vit B12, Vit D, Diptheria AntiToxoid, Tetanus Antitoxoid, EBV, and ds's immuno has ordered other labs, incl: lymphocyte enumeration panel, and Heme18

 

 

Anyway, not sure what Dr T usually orders, and obviously these are specific to my kids and where they are presently in their illness/treatment-- but thought it's at least give you something to go on.

 

HTH

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I do not see your doc, but I have worked in pharmacy, reviewed and signed insurance contracts and actually done home medical billing for a total of 20 years.

 

The first labs we had were the ASO and Anti-dnase. The lab said they were going to be 189.00. The insurance only allowed the lab to charge 18.82. Most insurance companies have what is called a MAC (maximum allowable cost) that they allow any provider to charge, even if you have not met your deductible yet (we had not met ours yet either.) Every insurance company has slightly different MAC prices and each insurance company has different contracts with their providers, so your company will likely be different.

 

Have the lab send you a bill after the insurance has reviewed the claim rather than paying up front and ask if you can pay in installments as well. The lab we went to asked us to pay the day of the draw, but when I told them I had no idea what the insurance was going to allow yet, they quickly agreed to send us a bill after the review.

 

You can also call your insurance company after the blood work is ordered with the names of the lab work, but before the blood draw and ask how much they will allow for each item so you will not be surprised. They may not "want" to answer, but they likely will if you ask them enough.

 

We also just had celiac, lupus, western blot (lyme) and the two thyroid test run and the insurance company allows around $35.00 for those.

Edited by Mayzoo
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Also, do different labs charge more than others?

 

Melanie

 

 

Sorry, I missed this part, but sorta covered it.

 

What your lab is allowed to charge is decided by your insurance company even though you have not met your deductible yet. 99.99% of the time, all labs that have signed a contract with your insurance company (listed as providers) will charge the same because the insurance company determines what is allowed, not the lab.

Edited by Mayzoo
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