The cost of healthcare continues to sky-rocket and surprise bills are no fun! Unfortunately, the cost associated with bloodwork to run some tests can vary widely and insurance coverage is not consistent across the board. So, as a consumer, what can you do? First off, a little education goes a long way! And a little groundwork on your end can save you serious cash. Labwork is a common step in investigation of chronic low milk supply and, especially if you have a new baby at home, there are plenty of other things competing for your finances! Don't spend more than you have too and I have several tips to save you money!
The Cost of Care
I'll start with an example from my own family. We have a high deductible PPO plan through a major national insurance company. Lab coverage varies but is generally “covered”. Late 2023, some bloodwork was done through my family member’s PCP and sent to the lab their office generally works with. One lab was a General Health Panel which included Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP) and Lipid panel. These are very basic labs and ones I almost always include when ordering low milk supply lab panels for my clients. In our case, this was the only General Health Panel done during 2023 and was “medically necessary” due to monitoring of a chronic health condition. Our out of pocket cost was $136 for this one panel. For one very basic lab panel…$136! A good learning opportunity for me and one that triggered some curiosity into the overall cost of labs and what I can do to help my clients keep costs under control.
Bloodwork for Low Milk Supply Investigation
So, what if you’re a new parent and labs have been recommended to investigate medical cause of low milk supply? There’s a variety of labs that can be helpful to get to the root of the problem but not all are appropriate for everyone. From screening for insulin resistance, anemia and thyroid imbalance to testing hormone levels and vitamins the cost of bloodwork can add up fast! If you are working with a Provider to investigate low milk supply, it’s so important that your labs are individualized as the “one size fits all” approach will likely lead to some unnecessary testing and more out of pocket cost for you. On the flip side, quite often Providers will either not order the right things or do very minimal labwork that doesn't really provide the information we're looking for. When doing a lab investigation into low supply, it's so important to partner with a Provider that knows what to order, how to interpret and then what to do about it! Unless your Provider also specialized in lactation, they likely do not have this skill set unless they have sought out additional training and education.
Planning for Labs to Investigate Low Milk Supply
Every Provider is different when it comes to knowing which labs are most beneficial for your situation. Some Providers will help you investigate, and others will not. Experience with lactating parents and comfort level for interpretation in the context of lactation also come into play. In my experience, most will do a few general tests and call it done. This is a tremendous disservice to you and there is usually much more to be done to get a complete picture!
Personally, I like to take a step-wise approach to lab investigation. First, I prefer to review any recent labs you have already had done...even if you were told they were normal. No sense in repeating labs unnecessarily and these results can contribute to the overall "big picture"! As a Nurse Practitioner and IBCLC, I am able to interpret your labs within the context of lactation and quite often "normal" is far from functional! In all cases, we will then come up with a plan together and this plan usually starts with testing for the most common underlying conditions that impact supply. Sometimes, I will recommend a second draw to dive a little deeper if needed based on the results of our initial labs. Hopefully, this will limit unnecessary labwork and keep your costs as reasonable as possible.
Orders and Testing: You Have Options
Talk to your Provider about your options for testing. As a Provider in private practice, I’m not bound by system contracts. I can offer several avenues for labs and always allow clients to choose the route that will work best for their unique situation. There is no financial benefit to me to do your labs at one center over another and it is always your choice! Let's look at the how and where of lab draws...
Traditional Lab Order (This is what occurs in most practices)
The order is either electronically sent or you take a printed copy to lab center of choice (LabCorp, Quest, etc.).
You can use insurance or self-pay. If you choose to have insurance billed, you will likely receive a bill for the portion you owe.
A caveat: Providers typically do not have access to how much labs will cost you and your out of pocket cost will vary greatly. And, every practice may charge something a little different. You can usually get a clue to what they'll cost by looking at old itemized statements.
Cash-pay Discounted Labs
Ask your Provider if they offer self-pay labs.
Some practices (like mine and Direct Primary Care offices) offer wholesale pricing with no markup on labs when ordered and paid for through the practice. For example, in my practice a General Health Panel (CBC, CMP, lipid panel) is <$20 and an initial thyroid panel (TSH, Free T3, Free T4, TPO antibody) is around $65.
Find out your cost ahead of time. For my clients, I can provide a no-obligation all-inclusive price quote and you will know exactly what your labs will cost with no surprise fees. This can be helpful as a comparison to what your cost would be through insurance.
As a virtual practice, for my clients, labs are drawn at your local LabCorp or Any Lab Test Now and I will receive results electronically.
Self-Ordered, Self-Pay Labs
For the majority of labs, you have access to self-ordered, self-pay labs. Most people are not aware of this but I am happy to counsel you on this process.
There are several companies that do this and cost may be less than what you would pay using insurance and pricing is clearly stated on their websites. Price varies widely between sites so do a little digging and look at more than one.
How it works: You request the labs yourself online and send the results to your Provider (or me). If you are seeing another Provider and expect them to review, it is wise to make sure ahead of time that they are willing to interpret and discuss with you but it is something I do for my clients! Not all Providers will interpret labs they "did not order".
If You Plan to Use Insurance Benefits for Labs…Do Your Research
A little research can go a long way and will stretch your healthcare dollars!
Whether you are doing insurance-covered labs through me or another Provider, I highly recommend you use the lab center preferred by insurance. In general, it would be considered “in-network” and this means lower cost for you.
Call your insurance company to verify coverage for labs. Find out what the “rules” are and what you will be responsible to pay for. This is especially important if you have a deductible you have not met. You may be responsible for 100% of lab cost in this case.
Then, call your preferred lab center to get an estimate on cost on the specific labs recommended for you. If you are self-pay, they have to provide a cost estimate to you according to the No Surprises Act.
In conclusion, it pays to be an educated consumer as the costs for healthcare seem to increase every year but insurance benefits decrease. In general, the more directly you can access services without administrative involvement (insurance billing, facility fees, payment collection, etc.) the lower your cost will be! Lab work is no exception, and costs add up fast, so know your options!
Information presented is educational only and not to be taken as medical advice. If you have specific questions about low milk supply investigation or would like to do labwork, let’s do a video visit and talk about it!