Negotiating lab and radiology prices can be difficult for new direct primary care doctors, but it doesn’t have to be. Armed with a few strategies and a few sample price sheets, you should be able to negotiate your way to lower prices for your patients and your community. This is important because you can actively lower the cost of healthcare for your patients and community, so remember that you’re doing the good work and you’re being a steward of health care resources.
Strategies to Get lower prices for lab work and radiology services
There are a few key strategies to get lower prices for your lab work and radiology services, and it starts with being persistent. You have to persistently negotiate on behalf of your patients and your community. I remember when we got our first price offering from Quest, the prices were astronomical. So I called rep after rep until I finally found the one who could help me get to a lower price. Sometimes it can feel like beating your head into a brick wall, as these are huge companies who don’t really care about small, independent practices. But, the squeaky wheel gets the grease, and you have to squeak loudly to get the prices you want.
The other option is to shop around and to show a sample price list, like the one below, to several different companies and have them match your price. All of this really comes down to persistence and being a tireless advocate for your patients and their pocketbooks.
Negotiating prices with the labs can be a little cumbersome, mostly because the sales team is usually a little harder to work with compared to other industries. But it's definitely worth it and a little persistence pays off in multitudes.
Logistically, when you work with a large lab company, you're going to want to ask for "client bill" prices. In this client bill set up, you will pay 100% of the bill each month directly to the lab, and then you will collect payment from the patients. This is fairly easy to automate, especially if you put your lab prices into your EMR.
Sample prices for laboratory testing in a direct primary care practice
That being said, here are some sample prices for our most commonly run laboratory tests. We contract with Quest diagnostics, but other physicians use LabCorp or smaller, independent laboratories in their communities. You can take a look around at the options available to you in your region.
Our basic lab panel
10231 COMPREHENSIVE METABOLIC PANEL $6.27
496 HEMOGLOBIN A1c $5.54 [83036]
6399 CBC (INCLUDES DIFF/PLT) $4.18 [85025]
7600 LIPID PANEL, STANDARD $5.21 [80061]
899 TSH $6.27 [84443]
Urinalysis and urine culture
395 CULTURE, URINE, ROUTINE $5.49 [87086]
7909 URINALYSIS REFLEX $2.65
Sexually transmitted infection panel
11363 CHLAMYDIA/N. GONORRHOEAE RNA, TMA, UROGENITAL $23.00 [87491, 87591]
36126 RPR (DX) W/REFL TITER AND CONFIRMATORY TESTING $4.18 [86592]
6447 HSV 1/2 IGG,TYPE SPECIFIC AB $16.21
91431 HIV 1/2 ANTIGEN/ANTIBODY,FOURTH GENERATION W/RFL $10.46 [87389]
Pap Testing Panel
58315 THINPREP TIS PAP $24.00 [88175]
90887 HPV mRNA E6/E7 $45.00 [87624]
Basic hepatitis panel
10306 HEPATITIS PANEL, ACUTE W/REFLEX TO CONFIRMATION $51.73 [80074]
499 HEPATITIS B SURFACE ANTIBODY QL $18.82
8472 HEPATITIS C AB W/REFL TO HCV RNA, QN, PCR $15.68 [86803]
Sample prices for radiology testing in a direct primary care practice
Here are the radiology prices that we have for our patients. We use a free-standing imaging center in the community that readily supplies a list of cash prices.
2D MAMM SCREENING W 3D TOMOSYNTHESIS 77067 + 77063 $260
2D DIGITAL MAMM SCREENING 77067 $185
CHEST 2 VIEWS 71046 $43
US ABDOMEN COMPLETE 76700 $165
US PELVIC 76856 $149
US TRANSVAG PELVIC 76830 $166
LUMBOSACRAL 4 VIEWS 72110 $70
DEXA HIPS PELVIS SPINE 77080 $55
MR LOW JOINT WO CONTR AST 73721 $316
MR LUMBAR WO CONTRAST 72148 $299
US BREAST LIMITED (NOT ALL 4 QUADRANTS) 76642 $119
CT ABD AND PELVIS W CONTRAST 74177 + Q9967 $464
If you’d like to see the full price list of our labs or our imaging, I can send you a PDF copy, just fill out the form below, with the subject “SEND ME YOUR PRICES”:
HOW CAN I LEARN MORE ABOUT STARTING AN DIRECT PRIMARY CARE PRACTICE?
If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our book and our courses on how to start and grow your direct primary care practice. We at Startup DPC have begun compiling some of the best content available on this blog, in our book, and in our courses.
The best place to start is to take our Direct Primary Care Business Plan course, available here. From there, you can learn how to attract new patients to your direct primary care practice and how to find the perfect location or build out the practice of your dreams.
Thanks for reading and watching, and best of luck in your direct primary care journey!
-Dr. Paul Thomas with Startup DPC