Costs of Hormone Testing
Hormone testing is often covered by insurance. This is because hormone problems can affect a man's general health in addition to their fertility potential, so most couples who have insurance will find it to be covered.
There is an amazing variation in the cost of hormone testing between labs, and also even within specific labs themselves. Some labs charges extremely high prices for certain labs and then give a discount (like 50%) if the patient does not have insurance and is paying out-of-pocket. Labs also sometimes have special low contracted prices either with certain insurance companies, or even with certain medical practices for their patients.
It is definitely in the interest of couples to do some research to find labs with reasonable pricing for their hormone tests. In the era of high-deductible policies, this is true even for couples who have health insurance.
The ICD-10 diagnosis code that I typically use for hormone testing is E29.1
Below is a list of hormone test costs from a few labs- these are updated as of April 2017. It contains a few national labs (such as Quest) as well as the special contract prices for patients of a certain female fertility clinic (LabCorp- contracted). For comparison, a local hospital (TriHealth) prices are also listed- both for no insurance (cash pay) pricing as well as the contracted rate for United Health Insurance.
I have also included the CPT codes for the tests so that you can run them by your local lab and/or insurance company.
Some fertility specialty companies also offer hormone profile panels for men. An example of this is Reprosource which offers the following panels:
1) Male ReproHormone Panel: $248 if no insurance ($137 if out of network insurance)
(T panel, estradiol, FSH, LH, prolactin, TSH, inhibin B)
2) Complete Male Hormone Profile: $235 if no insurance ($123 if out of network insurance)
(T panel, FSH, LH , estradiol, prolactin, TSH)
3) Standard Male Hormone Profile: $192 if no insurance ($117 if out of network insurance)
(T panel, FSH, LH, estradiol)
4) Follow-up Male Hormone Profile: $142 if no insurance ($105 if out of network insurance)
(T panel, estradiol)
Blood draws are coordinated locally and the blood is shipped to Reprosource for processing (3rd party phlebotomy costs $50 if not drawn at a contracted lab).