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Author Topic: The Cost Of Labwork  (Read 2770 times)

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Offline tednlou2

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  • Posts: 5,731
The Cost Of Labwork
« on: October 15, 2011, 02:35:32 AM »
Today, I got what looked like a bill from my lab.  I had never received a statement from them before.  It had $1,789 in big print at the bottom.  I got a little worried that my insurance didn't pay it for some reason and I would be responsible for it.  I called and they said they sent it to me in error.  A relief.

But, it educated me how much labwork costs.  I had no idea.  I thought $200-$300 at the most.  This was for the CBC, CD4, and viral load.  There weren't other things like cholesterol, STD screenings, etc.  So, this is how much the Ryan White program is spending every 3 months for those who qualify for that service?  And, for those without insurance but who make too much money to qualify, they have to pay this out of pocket?  Wow!  I had no idea and I'm embarrassed that I didn't have a clue.  It really made me understand why Ryan White needs all the funds it can get.  I mean, I knew it needed all the funds it could get to pay for meds.  I just didn't realize labs took up so much of the budget.  And, for those without insurance and have to pay for labs out-of-pocket, I can see why so many make the decision to stretch out getting labs done--which can be dangerous.  I know if I had to pay that out-of-pocket, we would be financially ruined after a year's labs--if not before. 

Why does it cost so much?  I realize CD4 counts are not a lab done usually, unless you have HIV or are sick with another kind of disease.  And, even with other diseases, I'm not sure how often they check your CD4.  Obviously, viral loads are only done on HIV patients.  So, I get that these tests aren't labs done hundreds of times each day at the average lab, so they are going to cost more.  But, almost $2-grand seems excessive.  I can only imagine the cost if I was getting my cholesterol checked, checked for the Heps, or checked to see if I developed antibodies to the vaccinations.  I'm sure it would have been $2,500 or more. 

I'm for universal health care.  It makes me think that if many of those against it got sick and found out how much things cost and the financial burden it takes on those without insurance but who make too much to qualify for assistance, they may (may) change their minds.   

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: The Cost Of Labwork
« Reply #1 on: October 15, 2011, 07:05:45 AM »
This is an example of the screwed up pricing structure of US medical care.

Almost no one pays that much.  The insurance plans have a contract with the labs that say they get a discount on the lab services.  Over time they have pushed for higher and higher discounts.  The labs get the overwhelming amount of their income from insured patients, so they agree to the higher discount and just raise the retail price so that they still get their money.

The result is that the retail price for lab work is often about 5 times the amount that insurers (or Ryan White) have to pay.

This is why it is so important to have health insurance, even if it isn't great insurance.  It gets you a discounted rate -- and the retail price is outrageous.

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline mecch

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  • red pill? or blue pill?
Re: The Cost Of Labwork
« Reply #2 on: October 15, 2011, 07:09:56 AM »
That is extremely screwed up pricing, because I just saw my bill for hiv labs and all the other blood work, cholesterol, etc etc. and it was a fraction, here in Switzerland.  Where there is universal insurance but it is all private companies, and where most medical care is also private.  The government however, does set price ranges for all medical services and drugs that are on the "must be covered" list.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline skeebo1969

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  • Posts: 5,879
Re: The Cost Of Labwork
« Reply #3 on: October 15, 2011, 11:53:34 AM »

  About 5 years ago I went to the ER for severe knee pain that occured only when I was sleeping.  It was terrible and my knee would totally lock up so that I couldn't bend it.  When I went to the ER I advised the doctor that I was HIV+.  So, he tested me for Hep C, which I didn't have.  During this time I did not have health insurance.  I was at the ER for 3 hours, and just had that one test done.  They sent me home still in pain, undiagnosed, and a month later I got a bill for $4,000 which I still have not paid.

  It turned out to be a torn MCL.
I despise the song Love is in the Air, you should too.

Offline buginme2

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Re: The Cost Of Labwork
« Reply #4 on: October 15, 2011, 02:39:40 PM »
Wow your lab is charging some sky high fees.

I just checked my last explanation of benefits from my insurance company and my charges are much less than yours.

For:  HIV Viral Load, CBC, CD4 count, Lipid Panel, chem panel. The medical center charged $887 however my insurance company states their "allowed amount" to be $521.  So If I didnt have insurance I guess I would have to pay $887 out of pocket but since they negotiate the amount before had I had to pay 10% of the $521.

My bill was $52

The bills I find rediculous are the HIV Genotype test.  That was $1700.

Also, just to walk into my Dr's office, he charges $400.  I doubt I spend more than 30 minutes with him. 

Its all so crazy...but...what can ya do?

Don't be fancy, just get dancey

Offline eric48

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Re: The Cost Of Labwork
« Reply #5 on: October 15, 2011, 07:35:18 PM »
...what can ya do?

Move to Canada ?

NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline J.R.E.

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  • Posts: 7,545
  • Joined Dec-2003 Living positive, since 1985.
Re: The Cost Of Labwork
« Reply #6 on: October 15, 2011, 09:59:02 PM »
Hello Ted !,   

I had a similar situation, happen to me back in 2007. Quest diagnostics, had sent me a bill for for labs. Not for that amount of money though. I'm glad you got it sorted out though ! Took me about a week and a half to get it sorted out.

You can read about it here:


The problem was caused by my doctor's office not submitting something or other, I payed the money but it was refunded back.

Take care------Ray
Current Meds ; Viramune, Epzicom, 20mg of Atorvastatin, 25 mg of Hydrochlorothiazide.
Amlodipine Besolate 5mg-- Updated 9/24/2017

Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 9/18/2017,  Viral load remains <40
CD 4 @358 /  CD4 % @ 13

 66 years young.

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: The Cost Of Labwork
« Reply #7 on: October 16, 2011, 01:27:06 AM »
just to walk into my Dr's office, he charges $400.  I doubt I spend more than 30 minutes with him.
Wow. now that's outrageous! >:(
leatherman (aka mIkIE)

All the stars are flashing high above the sea
and the party is on fire around you and me
We're gonna burn this disco down before the morning comes
- Pet Shop Boys

chart from 1992-2017

Offline mecch

  • Member
  • Posts: 13,406
  • red pill? or blue pill?
Re: The Cost Of Labwork
« Reply #8 on: October 16, 2011, 07:19:44 AM »
In the central european culture of minutia and exacting detail, a doctor's visit is broken down into dozens of little tasks / services that have been provided and each one has a little price range possible. I think each 5 minute segment with the doctor has a basic price for time, and then everything he/she says or does can have a value added.  Pity the medical secretary who has to figure this all out by what the doctor says.

“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline TheRoof

  • Member
  • Posts: 188
Re: The Cost Of Labwork
« Reply #9 on: October 16, 2011, 06:10:44 PM »
I agree, one aspect of HIV that scares me is horrible out-of-pocket cost.

I am all for a "Free-Market" Economy here in the States, BUT I definitively think Healthcare is something that needs to be delt with better control.

My roommate's Uncle went to Harvard Medical School and I asked him about his "view" on the current healthcare system. He said to me ... he believes "the system needs to be restructured, the current system does not suffice the needs of to many patients across his region of work" He ends up doing A LOT of Probono work to the chronic patients.

This doctor has his own private practice, and does a lot of Probono on the side. I am not sure about the "details" but it was interesting to get his view as wealthy doctor; who makes about a 7 figure salary annually.  
« Last Edit: October 16, 2011, 06:13:23 PM by TheRoof »

Offline phildinftlaudy

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  • Posts: 2,985
  • sweet Ann what you think babe...
Re: The Cost Of Labwork
« Reply #10 on: October 16, 2011, 07:39:51 PM »
My lab work from 9/22:

Quest billed my insurance: $1,006.85         Quest was paid by my insurance: $340.31

Since December 3, 2010 through October 14th, (approx. 10 months) the amount billed for my medical care and prescriptions has been: $68,878.79!    Avg. monthly amount = $6,887.88

So, by the time a 12-month period is up, it should top out at around $72,000 billed

The amount paid by my insurance has been: $29,754.85     Avg. monthly amount = $2,975.49

So, by the time a 12-month period is up, it should top out at around $32,000 paid by insurance

The amount I have paid out of pocket has been: $1,415.17 - Atripla co-pay assistance program of $660.00, so ACTUAL out of pocket: $755.17      Avg. monthly amount = $75.52

So, by the time a 12-month period is up, it should top out at around $850 out of pocket

I am extremely grateful that I have excellent insurance through my employer and for the Atripla co-pay assistance program.
September 13, 2008 - diagnosed +
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20


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