Short answer: A blood work bill usually comes from the lab that ran your test, not from the doctor who ordered it. Lab bills come in several types, from routine blood work to genetic tests and biopsy reviews, and each type has its own common errors. Under the ACA (Affordable Care Act), many screening tests should cost you $0 when an in-network provider does them, as listed on HealthCare.gov as of October 2026. Before you pay a lab bill, match it to your EOB (explanation of benefits), check the codes, and confirm the lab was in your plan's network.
Key takeaways
A blood work bill usually comes from the lab that ran the test, so it can arrive weeks after a visit from a company you may not recognize.
Under the ACA, screening tests the USPSTF rates A or B should cost $0 from an in-network provider in most plans, as of October 2026.
The No Surprises Act protects you from out-of-network lab and pathology bills tied to in-network hospitals and surgery centers, but generally not from a doctor's office.
Since January 1, 2021, hospitals must post their standard charges online, including a discounted cash price for people who pay cash.
People without insurance can dispute a lab bill that is at least $400 above the lab's good faith estimate, starting within 120 days of the first bill.
In this guide
Tell which type of lab bill you have and who sent it
Spot a screening test that should have cost $0
Read the lab codes on an itemized bill or EOB
Check an out-of-network lab bill against the No Surprises Act
Find your lab company and the payment options it lists
Ask the lab and your insurer to fix an error
What is a blood work bill?
A blood work bill is a charge for testing a sample of your blood, urine, or tissue. The sample may be drawn at your doctor's office, a hospital, or a lab's walk-in draw site. The test itself is often run somewhere else. That is why a lab bill can arrive weeks after your visit, from a company name you may not recognize.
Your EOB (explanation of benefits) is the place to start. An EOB is the statement your insurance company sends after it processes a claim. It is not a bill. It shows what the lab charged, what your plan paid, and what you owe.
Why might your blood work lab bill come from a separate company?
A lab bill comes from a separate company because the lab, not your doctor, ran the test. Your doctor's office collects the sample and sends it out. The lab then bills your insurance and sends you a bill for any balance. One visit can lead to two or three lab bills if your samples went to different labs.
A lab bill from a separate company can also mean a lab outside your plan's network. In-network means the lab has a contract with your health plan and agreed to set prices. Out-of-network means it has no contract, so it may bill you more. Your doctor may be in-network while the lab they use is not. Ask which lab your sample is going to before the draw if you can.
Which lab tests may cost $0?
Lab tests that count as preventive care should cost $0 in many plans. Under the ACA, most health plans must cover screening tests that the USPSTF (U.S. Preventive Services Task Force, an expert panel that grades screenings) rates A or B, with no cost sharing, per federal rules at 45 CFR 147.130. Cost sharing is your share of the cost, such as a copay (a flat fee), coinsurance (a percentage), or your deductible (what you pay before your plan starts paying).
HealthCare.gov's list for adults includes screening labs such as cholesterol, type 2 diabetes for some adults, hepatitis C for adults 18 to 79, HIV for people 15 to 65, and syphilis for adults at higher risk. Its list for women adds tests during pregnancy, such as hepatitis B at the first prenatal visit, Rh incompatibility screening, and gestational diabetes screening. It also lists BRCA genetic counseling for women at higher risk of breast cancer.
What is the difference between preventive and diagnostic lab tests?
The difference between preventive and diagnostic lab tests is the reason the test was done. A preventive test is a screening when you have no symptoms. A diagnostic test checks a symptom, a known condition, or an earlier abnormal result. The same blood test can be either one.
A diagnosis code on the claim tells your plan which it was. A diagnosis code is a short letter-and-number code for the reason you got care. If a routine screening was sent with a code for a symptom or condition, your plan may apply your deductible or coinsurance. Federal rules also let plans charge cost sharing for an office visit if the preventive test is billed separately from that visit. If you believe the test was a screening, ask your doctor's office whether it was coded that way.
How much does blood work cost without insurance?
Blood work cost without insurance depends on the lab, the test, and where your sample is drawn. A hospital lab may bill at hospital rates. An independent lab sets its own prices. The same test can cost very different amounts at each one, with or without insurance.
You can look up hospital prices before a test. Since January 1, 2021, CMS hospital price transparency rules require each hospital to post its standard charges online. CMS is the federal agency that runs these rules. Hospitals must show at least 300 shoppable services, or offer a price estimator tool, per 45 CFR 180.60. The posted charges include a discounted cash price, the price for a person who pays cash, per 45 CFR 180.20.
If you do not have insurance or choose not to use it, providers generally must give you a good faith estimate. A good faith estimate is a written estimate of expected charges. You can get one when you schedule care at least three business days ahead, or by asking, per CMS. Ask the lab for its own estimate. If a provider's bill is at least $400 more than its estimate, you can dispute it, starting within 120 days of getting your first bill.
Does the No Surprises Act cover lab bills?
The No Surprises Act covers some out-of-network lab bills. The No Surprises Act is a federal law, in effect since 2022, that limits surprise bills from out-of-network providers. Per CMS, it applies to emergency care and to care at in-network hospitals, hospital outpatient departments, and ambulatory surgical centers (clinics that do same-day surgery).
At those places, labs and pathologists are on a short list of providers who cannot ask you to give up your protections. If they are out-of-network, you should owe only your in-network cost sharing. Billing you for the gap between the lab's full price and what your plan paid is called balance billing.
The law has a gap that matters for lab bills. CMS says the protections do not apply at "a doctor's office that isn't a hospital outpatient department." If your doctor's office sent your sample to an out-of-network lab, the federal law likely does not cover that bill. You can still check it for errors, ask your insurer to review it, and negotiate. Our upcoming guide Out-of-Network Lab Bill After an In-Network Visit: What to Do covers this case.
How to check a blood work bill
Wait for the EOB. Do not pay a lab bill until your EOB for that lab claim arrives. Our guide to the EOB vs. medical bill shows how to line them up.
Match the bill to the EOB. Check the lab name, date of service, and the amount you owe. If the bill asks for more than the EOB says you owe, ask the lab why.
Find the bill type. Use the table below to name your bill type and its common errors.
Ask for an itemized bill. An itemized bill lists each test with its code. Our guide on why to request an itemized hospital bill explains how to ask.
Check the codes and network status. Look for repeated codes, extra units, a screening sent as diagnostic, or an out-of-network lab. Call your insurer to confirm the lab's network status on the date of service.
Ask for a fix in writing. Call or write to the lab's billing office with the error you found. Ask for a corrected bill and a pause on collections while they review it. Write down the date and the name of the person you spoke with.
Appeal if your insurer denied the claim. An appeal asks your insurer to review its decision. Our 48-hour plan for a denied claim walks through the first steps.
What is on a lab bill? Types of lab bills at a glance
A lab bill can be one of eight main types. Each type tends to come from a different sender and has its own errors to look for. Use this table to sort yours.
Type of lab bill | Who usually bills | How it is billed | Common errors | Where to check |
|---|---|---|---|---|
Routine blood work (CBC, metabolic panels) | Independent lab or hospital lab | One code per test or panel | Same test billed twice; panel and its parts billed separately | Itemized bill codes against the EOB |
Preventive screening labs | Independent lab or hospital lab | Should go through as preventive care, with a screening diagnosis code | Screening coded as diagnostic, so cost sharing applies | EOB cost sharing and the diagnosis code |
Urine drug tests | Independent lab or testing company | Screening test and confirmation test billed as separate codes | Confirmation testing you did not expect; many drugs billed at once | Itemized codes and units |
Allergy tests | Allergist's office or lab | Can be billed by the number of tests done | Units that do not match the number of tests done | Units column on the itemized bill |
STI tests (Sexually Transmitted Infection) | Doctor's office, clinic, or lab | Tests for different infections can be separate lines | Preventive screening billed as diagnostic | EOB cost sharing and the diagnosis code |
Prenatal labs | Lab, sometimes split between hospital and reference lab | Obstetric panel plus separate tests | Routine prenatal screening billed as diagnostic; duplicate panels | EOB for each lab, matched by date |
Genetic and genomic tests (NIPT, carrier screening, hereditary cancer, tumor testing) | Specialty genetic lab. NIPT (noninvasive prenatal testing) is a blood test in pregnancy that screens for some chromosome conditions. Carrier screening checks whether a parent carries a gene for an inherited condition. | Often its own code, sometimes a PLA code ending in "U" | Missing prior authorization; out-of-network lab; repeat tests billed at full price | EOB, prior authorization record, the lab's own assistance program |
Pathology and biopsy | Pathology group, separate from the surgeon and facility | A separate charge to examine the tissue sample | Out-of-network pathologist at an in-network facility | EOB network status; No Surprises Act rules |
Prior authorization is approval your plan requires before some tests. CBC stands for complete blood count.
How to read lab billing codes on an itemized bill or EOB
Lab billing codes tell you which test was billed. Most labs use CPT codes (Current Procedural Terminology), a set of five-digit codes kept by the American Medical Association. Each line on an itemized bill or EOB shows the code, the number of units, and the charge.
These common lab codes appear on the CMS shoppable services list in the 2019 hospital price transparency rule:
Code | Test | Notes |
|---|---|---|
80048 | Basic metabolic panel | Blood chemistry group |
80053 | Comprehensive metabolic panel | A wider group of blood chemistry tests |
80055 | Obstetric blood test panel | A panel used in pregnancy |
80061 | Lipid panel | Cholesterol and triglycerides |
84443 | Thyroid stimulating hormone (TSH) | Thyroid test |
85025 | Complete blood count with differential | Counts types of white blood cells |
85027 | Complete blood count, automated | Without the differential |
Genetic and specialty tests may use a PLA code (proprietary laboratory analyses), which names one lab's own test. AMA's PLA list shows these as four characters ending in the letter U, such as 0699U. If you see a U code, search the list for the test name and the lab.
Units matter too. A units column shows how many times a code was billed. If a test you had once shows two or more units, ask the lab to explain.
Common errors on lab bills
Industry research finds that 40% of medical bills contain errors. On lab bills, these are the ones to look for first.
Screening billed as diagnostic. Your EOB shows cost sharing for a test on the HealthCare.gov preventive list. Check the diagnosis code and ask your doctor's office whether it was coded as a screening or as diagnostic. Diagnostic care usually costs more out of pocket than screening care.
Duplicate tests. The same code appears twice on the same date, or on two bills from two labs. Match each code and date across your EOBs.
Panel and parts both billed. A panel code and the single tests inside it show up on the same date. Compare the codes against the itemized bill.
Wrong number of units. A test shows more units than you had. Check the units column.
Out-of-network lab you did not choose. Your EOB shows out-of-network cost sharing. Check where your sample was drawn and use the No Surprises Act section above if it was an emergency situation.
Prior authorization denial. Your EOB shows a denial for a missing approval, often on genetic tests. Ask the ordering doctor whether they requested approval, and ask your insurer about an appeal. Our guide on prior authorization denials explains who fixes this.
Bill sent before insurance paid. The bill arrives before the EOB, or shows the full charge. Ask the lab to bill your insurance first.
Lab companies Granted negotiates with
Granted may be able to help with bills from national labs, specialty genetic labs, and pathology groups. The table below lists lab companies whose bills we see often, the tests they commonly bill for, and the payment options each lab lists on its own website.
Additionally, many labs have an income based discount program. Eligibility for these programs often depends on your household income compared with the FPL (federal poverty level). The FPL is a yearly income measure set by the federal government, based on household size. Each lab sets its own rules, so check the lab's page before you apply.
Lab company | Tests you may see on the bill | Options for assistance |
|---|---|---|
Quest Diagnostics | Routine blood work, screening labs, and some genetic tests | A Patient Assistance Program based on income, household size, and the tests you had. People at or below 200% of the FPL may qualify, and some people up to 600% in certain cases. Payment plans by phone. Cash pay rates. |
Labcorp | Routine blood work and screening labs | Payment plans through the Labcorp Patient portal or by phone. A LabAccess Partnership program for people without insurance or whose plan does not cover lab tests, paid at the time of service. Cash pay rates and bill negotiation. |
Labcorp Women's Health | Prenatal screening, such as MaterniT 21 PLUS and MaterniT GENOME | Payment plans with no fees or interest. A financial hardship program that compares your family size and income to federal poverty guidelines. Call billing when your first bill arrives to ask for the application. |
Invitae (now part of Labcorp) | Genetic tests for hereditary cancer, heart conditions, and pregnancy | Bills and documents may come from Invitae or Labcorp. Its billing page covers a Financial Assistance Program and payment plans. |
Natera | Panorama NIPT, Empower hereditary cancer test, Signatera cancer test | Bills may show "Natera, Inc." or "Panorama." Financial assistance programs for people who qualify, with a Compassionate Care application. A cash pay rate for people who do not use insurance. |
BillionToOne | UNITY prenatal screen | UNITY's billing page says it accepts all insurance, including Medicaid, and offers payment plans and financial assistance. |
Myriad Genetics | MyRisk hereditary cancer test, Foresight carrier screening, Prequel NIPT, GeneSight | The Myriad Financial Assistance Program, based on your state, household size, and income. It is for people with private insurance or no insurance. Federal plans such as Medicare and Medicaid are generally not eligible. Interest-free payment plans. Bill negotiation also available. |
Guardant Health | Cancer blood tests, such as Guardant360 | The Guardant Access program. You enroll by signing the back of the order form. It checks whether you qualify for financial assistance and helps with insurance paperwork. |
Sonic Healthcare USA | Pathology, the review of a tissue or biopsy sample | Bills separately from your doctor. Its billing FAQ lists a prompt pay discount for people who pay on their own, financial hardship policies, and payment plans available by phone. |
If your lab is not on this list, we can still help. We review bills from any lab, including hospital labs and local pathology groups.
Granted is not affiliated with or endorsed by the labs listed. Lab programs can change, so the lab's own page has the current rules.
How Granted can help lower your lab bills
Granted Health reviews your lab bills and EOBs side by side. We check the codes, the units, the network status, and whether a screening test was billed as diagnostic. If a lab bill looks wrong, we contact the lab's billing office and your insurer to ask for a corrected bill. If a lab offers its own income based discount program, like the ones in the table above, we check whether you may qualify and can apply with you. If your insurer denied a lab claim, we can review the denial and the EOB, gather records, and file an appeal with your OK.
If you are looking at a bill like this one, upload it and get a second look before you pay. Free to start. You only pay if we lower your bill. Check your bill
Frequently asked questions about lab bills
Why did I get a separate bill for blood work?
You got a separate bill for blood work because the lab that ran the test bills on its own. Your doctor's office drew the sample and sent it to a lab, which billed your insurance and then you. Match the lab bill to its EOB before you pay, since the lab may have a different network status than your doctor.
Should my blood work be covered at 100%?
Your blood work should be covered at 100% if it was a preventive screening on the HealthCare.gov list, done by an in-network provider, under a plan that is not grandfathered. Blood work to check a symptom or condition is diagnostic, so your deductible, copay, or coinsurance may apply. HealthCare.gov notes that $0 cost may not apply in all cases.
Why was my preventive lab test billed as diagnostic?
A preventive lab test is billed as diagnostic when the claim carries a diagnosis code for a symptom or condition. This can happen if you mentioned a symptom at your visit, or if the code was entered by mistake. Ask your doctor's office to review the code. If it was a routine screening, ask them to correct and resend the claim.
What should I do about an out-of-network lab bill?
For an out-of-network lab bill, first check where the sample was taken. If it was at an in-network hospital, outpatient department, or surgery center, the No Surprises Act likely limits you to in-network cost sharing. If it was a doctor's office, the federal law likely does not apply, but you can still ask your insurer to review it and negotiate.
What do the codes on my lab bill mean?
The codes on your lab bill name each test that was billed. Most are five-digit CPT codes kept by the American Medical Association, such as 85025 for a complete blood count. Genetic tests may use PLA codes ending in the letter U. Check the units column too, since extra units can mean a test was billed more than once.
What does Granted charge to help with a lab bill?
Granted is a digital health advocate that reviews medical bills, finds billing errors, negotiates with billing offices, and checks your eligibility for income based discounts. It is free to start, and you only pay if we successfully lower your bill. Our fee is 10% of the negotiated savings, capped at $300 per bill.
Key terms in this post
Explanation of benefits (EOB): the statement your insurer sends after it processes a claim; it is not a bill.
Preventive test: a screening done when you have no symptoms, which many plans cover at $0 in-network.
Diagnostic test: a test that checks a symptom, a known condition, or an earlier result.
Cost sharing: your share of the cost, such as a copay, coinsurance, or deductible.
CPT code: a five-digit code that names a medical service or test on a bill.
PLA code: a code ending in U that names one lab's own test.
In-network: a provider or lab with a contract with your health plan.
Balance billing: billing you for the gap between a provider's full price and what your plan paid.
If you have a lab bill that you want to check
Upload it and we will review every charge, look for opportunities to lower what you owe, and handle the work with you. Free to start. You only pay if we lower your bill.
Connect your insurance, too. We cover 1,300+ insurance plans, so we can see your bills and claims together and keep an eye on them between visits.
Each bill is different, and results vary.
This is general information, not legal or tax advice.
Sources & More information
eCFR, 45 CFR 147.130, Coverage of preventive health services: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-B/part-147/section-147.130 (checked Oct 23, 2026)
HealthCare.gov, Preventive care benefits for adults: https://www.healthcare.gov/preventive-care-adults/ (checked Oct 23, 2026)
HealthCare.gov, Preventive care benefits for women: https://www.healthcare.gov/preventive-care-women/ (checked Oct 23, 2026)
HealthCare.gov, Grandfathered health plan (glossary): https://www.healthcare.gov/glossary/grandfathered-health-plan/ (checked Oct 23, 2026)
HealthCare.gov, Preventive health services: https://www.healthcare.gov/coverage/preventive-care-benefits/ (checked Oct 23, 2026)
AHRQ, USPSTF welcomes new members at orientation and first meeting: https://www.ahrq.gov/cpi/about/otherwebsites/uspstf/new-members.html (checked Oct 23, 2026)
USPSTF, BRCA-related cancer risk assessment, genetic counseling, and genetic testing: https://www.uspreventiveservicestaskforce.org/uspstf/document/ClinicalSummaryFinal/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing (checked Oct 23, 2026)
CMS, Hospital price transparency: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency (checked Oct 23, 2026)
eCFR, 45 CFR 180.60, Requirements for displaying shoppable services: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-E/part-180/subpart-B/section-180.60 (checked Oct 23, 2026)
eCFR, 45 CFR 180.20, Definitions: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-E/part-180/subpart-A/section-180.20 (checked Oct 23, 2026)
Federal Register, Price Transparency Requirements for Hospitals To Make Standard Charges Public, November 27, 2019: https://www.govinfo.gov/content/pkg/FR-2019-11-27/html/2019-24931.htm (checked Oct 23, 2026)
CMS, Know your rights when using insurance: https://www.cms.gov/initiatives/your-patient-rights/medical-bill-rights/know-your-rights/insurance (checked Oct 23, 2026)
CMS, Know your rights without insurance: https://www.cms.gov/initiatives/your-patient-rights/medical-bill-rights/know-your-rights/without-insurance (checked Oct 23, 2026)
American Medical Association, CPT code set overview: https://www.ama-assn.org/practice-management/cpt/cpt-code-set-overview (checked Oct 23, 2026)
American Medical Association, CPT PLA codes long descriptors: https://www.ama-assn.org/system/files/cpt-pla-codes-long.pdf (checked Oct 23, 2026)
Quest Diagnostics, Financial assistance: https://www.questdiagnostics.com/patients/billing-insurance/financial-assistance (checked Oct 28, 2026)
Labcorp, Payment programs: https://labcorp.com/frequently-asked-questions/patient/billing-insurance/payment-programs (checked Oct 28, 2026)
Labcorp Women's Health, Financial assistance: https://womenshealth.labcorp.com/patients/billing/financial-assistance (checked Oct 28, 2026)
Invitae, Patient FAQs: Billing: https://www.invitae.com/en/individuals/billing (checked Oct 28, 2026)
Natera, Oncology billing: https://natera.com/oncology/billing (checked Oct 28, 2026)
Natera, Compassionate Care application: https://www.natera.com/resource-library/panorama/compassionate-care-application/ (checked Oct 28, 2026)
BillionToOne UNITY, Patient billing: https://www.unityscreen.com/patient-resources/patient-billing-brochure (checked Oct 28, 2026)
Myriad Genetics, Financial assistance: https://myriad.com/affordability/financial-assistance/ (checked Oct 28, 2026)
Guardant Health, Guardant Complete patient brochure: https://www.guardantcomplete.com/assets/pdf/Guardant_Complete_Patient_Brochure.pdf (checked Oct 28, 2026)
Sonic Healthcare USA, Billing FAQ: https://sonichealthcareusa.com/ap/patients/billing-faq/ (checked Oct 28, 2026)