Are Labs Really Cheaper at a DpC Office? I Pulled My Own Numbers to Check.
Are labs really cheaper at a direct primary care office? I get some version of this question a lot, usually from someone who's skeptical — rightfully — of anything that sounds too good to be true in healthcare.
So instead of telling you, I pulled my own numbers.
What members actually pay — compared to published self-pay prices
Here's what four of the most commonly ordered labs cost as a B2 Direct Care member, next to the published self-pay prices at a major national lab chain (Labcorp OnDemand's own advertised cash rates - public, and you can look them up yourself):
TSH (basic thyroid check): $2.75 as a member vs. $49 self-pay - about 94% less
Lipid Panel (cholesterol): $5.40 as a member vs. $59 self-pay - about 91% less
Hemoglobin A1c (diabetes screening/monitoring): $3.58 as a member vs. $39 self-pay - about 91% less
Vitamin D: $16.52 as a member vs. $99 self-pay - about 83% less
And that's the published, advertised self-pay price. Route the same tests through a hospital lab, or through insurance before you've met your deductible, and the number you're quoted can run considerably higher - often into the hundreds per test.
How this is legal, and why it's not a trick
I have a direct-bill account with a national reference lab, priced for practices that order outside the insurance billing system entirely — no claims, no coding, no collections overhead baked into the price. I'm intentionally not naming which lab, because the specific vendor isn't really the point. Most reference labs offer some version of this pricing to direct-pay practices; the structure is what makes it possible, not a special deal unique to me.
The part that matters for you: I don't mark it up. What I'm charged is what shows up on your bill. If a test costs me $2.75, it costs you $2.75. No line-item padding, no "facility fee," no surprise. This is a pass-through, not a discount I'm dressing up.
What this doesn't cover — the honest part
I don't want to oversell this, so here's where it has real limits:
It's routine, common labs. The panels above are the bread-and-butter tests ordered in primary care - thyroid, cholesterol, metabolic, diabetes monitoring, that kind of thing. Highly specialized send-out tests, genetic panels, or anything requiring a hospital lab can run higher, and I'll tell you upfront if that's the case before you're on the hook for it.
It's not always the better deal if your insurance is already good. If you have a low-deductible plan and you've already met it for the year, your labs might genuinely be $0 out of pocket through insurance. Cash-pay-through-membership isn't automatically cheaper than "free" — it's cheaper than what most people are actually paying, which is retail self-pay or an unmet deductible. Do the math for your specific plan.
A cheap number on a lab slip still needs a doctor behind it. The savings is on the test. It doesn't replace the part where I look at your results, put them in context with the rest of your history, and tell you what actually matters versus what's noise. That's still the job — the lab price is just one less obstacle between you and getting it done.
Why I'm showing you the receipts
I could just tell you "labs are cheaper here" and ask you to trust me. But this is the same conversation I've had about the direct-care + high-deductible-plan pairing generally — the model only makes sense if the numbers hold up to scrutiny. So here they are.
If you're weighing whether this fits your situation — especially with open enrollment coming up this fall — happy to walk through your specific labs and what they'd actually cost. No obligation, no hard sell.
Brian Bost, MD, MPH, is a Med-Peds physician and Physician-Founder of B2 Health Solutions and its clinical practice, B2 Direct Care — a hospitalist-informed, solo DpC micropractice in Denver, Colorado.
