Facts of Laboratory Health Care Costs

In today’s ever-complicated health care environment, it is very difficult to keep proper management of your health without losing control of your finances.  When it comes to health insurance, multiple health insurance companies offer different plans with variable deductibles, co-insurances, co-pays, and coverages.  All of this can simply cause a headache.

The same complications go for choosing physicians, hospitals, radiology or laboratory services.  You may be in-network at your physician’s office and be out-of-network at a radiology office or laboratory. In the end, you may be paying 2–7 times more for the same service you could have received elsewhere.

Here at BCL, we will clarify the service and cost for your laboratory testing needs so you can make an informed choice.

Laboratory Type:

There are typically four (4) types of laboratories in Massachusetts.  These are
1) in-office physician labs,  2) private independent labs,  3) national labs, and  4) hospital based labs

  • Hospital labs are within a hospital and are managed by the hospital for both in-patients and out-patients.
  • National labs are generally publicly traded companies that are either national or international.
  • Independent local labs are typically regional, privately owned laboratories such as BCL.  We have full service reference license and provide an array of services.
  • In office physician labs are managed by a group of physicians and have limited testing menu.  They cannot accept samples from outside of their physician group.

Laboratory Price:

At a minimum, all labs provide the same basic service; however, some labs opt for higher standard of inspection and procedures as does BCL, by our certification from CAP.  Nevertheless, not all similar lab testing cost the same. In realty, the same lab test(s) may cost up to 2-5 times more depending on where you choose your samples to be sent.  Yes, you have a choice and your physician has to accept your choice.

Laboratory Price Structure:

  • Hospital based labs are typically the most expensive as they have much higher cost of operations.  The higher costs are passed to patients when deductibles and co-insurances apply.
  • National based labs are typically the second most expensive as they have shareholders and have higher reimbursements from health insurance companies.  Higher costs are passed to patients when deductibles and co-insurances apply.
  • Local private labs are typically the least expensive, due to their size and limited national exposure.  The low costs translate to savings for patients.  This is how BCL offers much lower prices.
  • In office physician labs are on the higher end pricing as they typically get their pricing from their hospital affiliation.

 In-network vs. Out-of-Network:

As you may have seen on your explanation of benefits (EOB), some of the healthcare services you receive may be in-network or out-of-network.  Depending on which it may be, you are charged different fees, have different co-pays, different deductibles, and co-insurances.  The same applies for laboratory services.

BCL holds contracts with Medicare, Medicaid, BC/BS, Tufts, Harvard Pilgrim, NHP, Network Health, and most other health insurance companies.  In the event BCL is out-of-network for your plan, our low fee schedule will still save you money on your lab services.

Did you know?

All patients have the right to choose which laboratory they wish to use.  In Massachusetts, it is illegal for laboratories to contract with physicians; therefore, the patient has the freedom of choice.

Why choose BCL:

  1. RESULTS –  We have one of the fastest turnaround times for result reporting.  Most tests are performed the same night as your sample arrival, and your physician will have your results by the next morning.
  2.  ACCURACY –  We are licensed by both CLIA88 and Massachusetts department of public health.  We are also voluntarily certified by the stringent College of American Pathologists (CAP).
  3.  PRICE –  Our prices are 2-5x less than hospital-based labs and 1-3x less than national labs.  We are the least expensive laboratory in Massachusetts

How to choose BCL?

  • Choose one of our convenient patient service centers by going to the “contact us” page.
  • Ask your physician to send your blood work to BCL.  If your physician does not routinely use our services, they can call our lab at 781-893-1995 for same day pickup by one of our couriers.