Do vets routinely add $$ to blood tests?

[twostinkydogs]

I recently had my vet run blood tests on my horse who has been showing signs of neurological issues. I compared the charges on my bill with the test prices on the UC Davis and Cornell websites and it’s a $500 difference. I can understand additional fees for handling the blood work and postage, but $500 seems like a lot!

What am I missing? Is this fairly standard? This does not include the farm call or the exam time, those were extra. This is a newer vet to me and I never seem to have a visit that’s less than $1K.

IFAT Panel: vet $300, UC Davis $142
Selenium: vet $90, UC Davis $23
PSSM: vet $110, UC Davis $40
Lymes: vet $140, Cornell $47
Vitamin E: vet $166, UC Davis $55

edited to add vitamin E

[poltroon]

I’m not clear what market you’re in which would affect what lab you’re running through. It’s not inconceivable to me that UC Davis, using its in-house laboratory, might be able to run the tests quite a bit less expensively than your vet who may be using a third party for-profit lab (and with potentially significant handling to get a fresh sample to them).

So: first, I’d ask your vet about charges, and why those are, and know what they are ahead of time.

Also, if you have a horse with neurological issues, it may well be worth your time to haul to UC Davis or Cornell if one of them is accessible to you and get the exam work done there - they have simply more equipment and tools to do a very thorough workup than can be done in the field. The cost and time to haul in may well be worth it, and in my experience UC Davis is cost-competitive with the multiple farm call visits you might be facing for something nebulous.

On the other hand, it might well cost $500 to haul your horse in and so doing that work in the field may still be more convenient and less expensive.

[Simkie]

Yes, that’s typical. Your vet has costs associated with lab work beyond the lab charge.

A Lyme (no “s”) titer is nearly $200 around here.

[mmeqcenter]

The prices for UC Davis online mean you have to buy/do everything to get the samples there. Needles, syringes, collection tubes, labelling, shipping and packaging. So, the difference in prices doesn’t really seem all that crazy to me. On top of that, unless you know for sure that your vet sent the samples to UC Davis, you really have no idea what the lab they use charges.

[emeraldcity]

Not to mention buildings, heat, electricity, staff salaries… Yes, of course your vet marks up every single thing (pretty much) they do. And not nearly as much as they would really need to to pay staff a living wage in most cases.

[Ben_and_Me]

You also aren’t paying just for the supplies, lab tests, etc. You are also paying for the vet’s professional knowledge to interpret the bloodwork in relation to your horse’s physical exam, history, and other diagnostic tests, and to use this information to come up with a treatment plan.

[WildGooseChase]

Between supplies, liability, time and interpretation, I don’t think this is wildly out of the ballpark. There are other costs associated with lab work than the cost to run the test. Sure, you’re paying for the services, but they won’t mean anything, or appear skewed to you unless you have a DVM to interpret the results.

I also wouldn’t use UC Davis as a comparison unless that’s the laboratory you vet used to test your horses samples specifically, and those tests were within the last 7 days. Pricing varies between laboratories and can change over time due to the rising costs of literally everything.

[twostinkydogs]

Thanks for all the replies, I really appreciate it. I’m at $15k in vet bills for the year and was hoping for some relief.

[candyappy]

@twostinkydogs

IFAT Panel: vet $300, UC Davis $142
Selenium: vet $90, UC Davis $23
PSSM: vet $110, UC Davis $40
Lymes: vet $140, Cornell $47
Vitamin E: vet $166, UC Davis $55

edited to add vitamin E

@twostinkydogs

This does not include the farm call or the exam time, those were extra.

Sorry but compared to UC Davis your vets prices seem outrageous to me. Especially since it was just the bloodwork. My vets know to tell me what something is going to cost before I ask ( if at all pricey) and that is not a bad thing!

[Bonnie2]

Ask your vet. If you ask politely, you should get a polite honest answer. If the vet is defensive that is also an answer.

[Texarkana]

@twostinkydogs

This is a newer vet to me and I never seem to have a visit that’s less than $1K.

Unfortunately this is the direction the cost of vet medicine is heading.

Some vets are definitely pricier than others, though.

Years ago when I did billing for a vet hospital, the standard markup was 300%. Your prices fall right in line with that. That’s because you are paying for the vet’s time and knowledge, you are paying for their equipment, you are paying their staff.

It’s hard to say if your vet is unnecessarily charging you without knowing more info, but the lab prices alone look to be very standard.

[Pezanos]

Your vet prices seem to be in line with what I’ve paid for the same tests. The UC Davis prices are amazingly low. Way, way lower than I’ve ever paid.

[barnesthenoble]

As someone else mentioned, the UC Davis prices are just the costs of the tests. Even if your vet was having the tests run at Davis (which is certainly a possibility), unless they’re close enough to drive the sample themselves there is the cost of overnight shipping ($) something that needs to stay cold ($$) and is considered a biological sample ($$$). There is the office time of either a staff member or the vet themselves spent coordinating shipping, making sure it gets dropped off, and filling out the proper paperwork both for the lab and for the shipment. All without factoring in the cost of needles, syringes, etc etc. And the lab frequently charges a specimen disposal fee in addition to the test, as well. And UCD actually has pretty reasonable rates for their tests–there are private labs that are 3x as much. So without knowing whether your vet actually ran the tests through Davis, it can’t be an apples to apples comparison.

Also of note, I’ve had multiple animals treated at UCD and the tests had additional markups to the above, explicitly for handling of samples, supplies etc. The prices on you listed are the referring vet’s cost for the test. Not what is actually charged to clients.

I totally understand the frustration, and I’ve definitely paid some bills that had eyebrow-raising markups. And it’s eye-watering how expensive vet med has become. I wish I had a better answer because the financial strain is real.

[IPEsq]

I don’t think there is a standard. I know some practices that upcharge an insane amount on things like tests, medications. Others don’t (or outsource more) in the interest of the overall client relationship and having a client more willing to pay for more services oriented work because they see the value in that and the budget doesn’t get eaten up so much by the upcharge on other costs. And then there’s a mix of both.

I will pay a modest upcharge for the convenience of getting certain meds straight off the truck, for example, and I’ll gladly do that also to preserve my relationship with the vet rather than always having them deal with online pharmacies for me. But there are some vets I’ll never buy meds from again because it’s just insane.

I work in legal services where some things are charged on a flat fee rate (and we have government fees to pay and vendors we use for some things that add to the costs), and we do this kind of dance with clients as well.

[MadTrotter]

I second the call to take complicated cases to a teaching hospital. I have three tiers of vet care: 1. a dependable private practice that will come out for routine immunizations/coggins/drain abscess and I would trust for first-line emergency; 2. a large clinic with surgery that is fairly close and clinic 1 would refer me to; 3. university teaching hospital where I would go with non-emergent complex cases.

If it’s a privately owned practice, ask in advance for treatment plans on different tiers. You might sacrifice speed in diagnosing vs the “kitchen sink” approach to testing.

[PaddockWood]

I’m curious what your PSSM test represents. There’s the hair test that you can send direct to Davis yourself and then there is the biopsy right? The hair test was what $40? Then I did a biopsy to Michigan and that was over $1k all in.

I just ran blood to check various things. Fam call of $77 and then all sent to Cornell:
ACTH/insulin - $94
Vitamin E and Se - $140
CBC chem - $190
Iron - $20

[4horses]

My small animal vet adds about $150 worth of padding to the bill on some things.

My local equine vet adds money to the cost for medications. I compared her prices to the university and the university turns out cheaper with better quality care. Obviously the exam fees are a bit higher at the university but they tend to be more accurate at getting a diagnosis and treatment plan. I’ve afraid my local vet has lost my business. I would rather pay a bit more and know my animal is getting the care it needs, then waste money on poor quality care and have to repeat tests elsewhere.

[Ghazzu]

I was “taught” that the standard markup was to double what the lab charged me–that covers the supplies and drawing of the sample, the work and cost of submitting it, and the interpretation of the results.

[twostinkydogs]

I am in Montgomery County, Maryland. I think our price ranges are fairly expensive - maybe not NYC or LA expensive but higher than average. A full set of basic shoes cost me $270.

Up until last year, I was really lucky that my horses have been healthy. I’ve not dealt with any kind of testing beyond a regular CBC and metabolic workups until now. I was just really surprised by the discrepancy but I don’t disagree the interpretation is worth the cost.

[Willesdon]

Your vet treats tens of horses, the university animal hospitals treats thousands. Economies of scale.