Laboratory tests are helpful in determining the cellular and chemical nature of the blood. They can give your doctor clues to current illnesses or identify potential risks for future medical problems.
Common tests include a chemistry panel which may be more or less inclusive. The Chem 7 or Basic Metabolic Panel (BMP) is used to assess kidney function (BUN and Cr), electrolyte balance (such as sodium, chloride and potassium), blood sugar (glucose) and acid/base status (CO2).
The Comprehensive Metabolic Panel (CMP) is a more detailed evaluation including the components of the BMP and adding liver function tests as well as a few minerals like calcium (Ca).
The lipid panel is an evaluation of blood cholesterol and it breaks the total cholesterol into its component parts. HDL is the “good” cholesterol so the higher the value the better. LDL is called the “bad” cholesterol, as it has been implicated in the development of hardening of the arteries (atherosclerosis) and increasing the risk for kidney disease, heart attack and stroke. Also included in the lipid panel are the triglycerides (TG). Triglycerides are non-cholesterol fats but may also play a role in atherosclerosis especially at higher values.
The Complete Blood Count (CBC) looks at the cellular components of the blood. These are divided into the white blood cells (the bodies defense against foreign invaders like bacteria and viruses), red blood cells (which carry oxygen and nutrients to other cells) and platelets (which are important in the clotting process).
The components of these profiles are essentially the same no matter where the test is done. However, labs may have slightly different reference normals based on the controls that they use. All labs should include the normal ranges adjacent to the test result.
The government, through its accreditation process, monitors the accuracy of the laboratory’s results. This insures that values are reproducible and can be used as comparisons from one test to another even at differing sites.
However, the cost of obtaining these tests may vary widely from location to location. For example, prior to a recent shoulder surgery, I was asked to obtain a BMP. Because it was a day prior to surgery, I opted to have the test done in the office where I worked. As an independent physician, I was able to obtain this test for my patients at a cost of $25. This covered our costs and a small profit. So you can imagine my surprise when I received a bill of $12 for drawing the blood and $225.75 for the test.
If I would have had the time, I could have gone to the website: www.saveonlabs.com and gotten the same test for $19.25 + a $15 administration fee. However, this lab will not submit the cost to insurance. I am not aware of what other labs are doing, so I would appreciate your input and I will make this information available in the future. If you know of a lab where standard tests are priced reasonably, please forward us the information so we can share it.
In the interim, I would recommend pricing your lab work prior to having the tests done. Furthermore, as health care consumers, we should be encouraging our insurance companies and the government to prevent price gouging and cover our costs when we seek more cost effective alternatives.
Next Week will be “Understanding Your Blood Tests: The BMP”.