When we pay for health insurance, it’s difficult to wrap our minds around paying out-of-pocket for services not covered under our insurance plan. And sadly, if you’re looking to get functional and integrative care, most insurance companies have not caught up with the time yet, and don’t cover these services. At the end of the day, the total expenses can often times make integrative care cost prohibitive. On top of the $500 / per hour office visit fee, lab testing and supplements can be hidden expenses that surprise people after their first appointment.
However, it’s rare that you’ll find the price of labs & supplements written on a functional medicine doctor’s website (much less the cost of their visits).
To close the gap in cost transparency, we cataloged the most commonly ordered functional medicine tests, and their prices below.
Some of the confusion around pricing comes from a few factors:
- Different states have different regulation & thus sometimes different pricing
- Different providers are registered with different laboratories. For example, for a urine amino acids test, a provider can go through Genova or Doctor’s Data - which are different companies with different prices for a similar test.
- Some labs will accept insurance — but the only way to find out how much insurance will cover is to get the CPT codes from your provider & the lab for the exact test, call your insurance, and get them to tell you how much they will cover. (and even then, it’s not a guarantee) You’ll usually need to pay out of pocket upfront, even with insurance coverage, though. Additionally, providers report that insurance companies are becoming more stringent on coverage for functional medicine lab testing.
- Providers generally contract specific rates with the lab companies & then mark the labs up at different rates based on their business model, time spent going over the lab, etc.
Pricing can be complicated, however, what you need to know is on average, patients are spending $500 - $1000 on testing after an initial visit with a functional medicine provider.
Here’s a subset of popular lab testing and their average prices.
Genova GI Effects: $500 - $600
What it is: Comprehensive Stool Testing
Insurance: Will bill insurance, but no guarantee. Sometimes partially covered.
Examples of where to purchase without having to go through a provider: TrueHealth Labs or Direct Labs. It looks at digestion/absorption levels, Inflammation levels, presence of parasites and worms, your gut microbiome breakdown, and bacteria including h. Pylori, Campylobacter, and Clostridium difficile (c diff).
Precision Analytics DUTCH Test: $400
What it is: Comprehensive hormone panel
Company: Precision Analytics
Insurance: No insurance coverage
Can purchase directly from Precision Analytics site.
Cyrex Food Sensitivity Panel: $200 - $700
What it is: Reputable food sensitivity diagnostic
Insurance: No insurance coverage
Examples of where to purchase without having to go through a provider: TrueHealth Labs.
p.s. Want to learn more about ordering your own food allergy testing? Start here.
SIBO Breath Test: $200
What it is: This can diagnose or rule out SIBO
Company: Many different companies, Genova, etc.
Insurance: Sometime partially covered by insurance.
Examples of where to purchase without having to go through a provider: Direct Labs.
Of course, testing is rarely mandated from the provider, and they will work with you to make it work within your budget. However, if you opt to work with a functional medicine provider, part of the benefit is getting access to and interpretation of specialty lab testing and diagnostics you aren’t going to get from your conventional doctor.
Ready to see a functional medicine doctor to get to the root cause of your allergies, sensitivities, or intolerances? 👇