The costs of home tick-tests or laboratory tick-testing is usually not covered by insurance and, in some cases, neither is the Lyme disease test cost for patients themselves. Where testing is deemed necessary by a patient’s physician the costs are usually able to be claimed on insurance but the raft of tests needed to achieve any reasonable confidence in diagnosis can make Lyme disease tests a costly affair. An initial enzyme-linked immunosorbent assay (ELISA) or immunofluorescent assay (IFA) test will usually lead to a Western blot test if the results are borderline or positive. Patients may wish to have a Western blot test even in the case of a negative ELISA or IFA as the accuracy of Lyme disease tests has been questioned by several studies particularly in late stage Lyme disease where ELISA is thought to be quite inaccurate.
Testing for Co-infections with Lyme Disease
Lyme disease often occurs alongside co-infections such as ehrlichiosis, babesia, and rickettsia, with several labs offering a full-screening for these diseases from a single sample. Some doctors suspect the presence of babesia in around 20% of Lyme disease cases, although sub-clinical cases may be hard to spot. There have also been suggestions that Lyme disease is made more difficult to treat without first eradicating babesia. As the other co-infections mentioned all respond to the antibiotics usually used for Lyme disease itself, these are, perhaps, less of a worry for those being treated for Lyme disease. Babesia however is not cleared by doxycycline (the antibiotic used in Lyme disease treatment) and alternative measures may be necessary to help treat this co-infection should it be detected.
The cost of testing for Lyme disease and co-infections can be high, which can cause financial hardship for patients whose symptoms may be preventing them from working, or where several family members are affected. The lack of support by many doctors for a diagnosis of Lyme disease, usually due to poor knowledge of the disease, can also cause obstacles to testing. Where a sympathetic doctor is happy to sign off on a script for a Lyme disease test, such as ELISA, IFA, or Western blot, a patient may be able to have the cost of having their blood drawn covered by insurance; they will usually still have to pay for the test itself however.
Variety of Tests for Lyme Disease
There are a variety of tests available, including ELISA and Western blot tests that simply look for antibodies to Borrelia burgdorferi. These tests tend to be considerably cheaper than the more comprehensive test panels for Lyme disease and are priced at around $100. IgeneX offers a Lyme disease test including Western blot IgG, WB IgM and Lyme disease IFA for around $260 and an initial Lyme panel with WB IgG, WB IgM, and Lyme PCR serum for around $420.
Immunoscience and IgeneX both offer testing by either ELISA alone or ELISA with Western blot methods for a wide range of tick-borne antigens including Borrelia bacteria found more commonly in European countries and likely co-infections such as ehrlichiosis, babesiosis, and rickettsia. The cost of drawing blood will likely be covered by insurance for most patients but it appears sensible to order a full panel in cases where Lyme is strongly suspected in order to facilitate the commencement of any necessary treatment. Complete co-infection panels cost around $600-700 from IgeneX, and $400-500 from Immunosciences.
Patients should be aware that the cost of the appointment with a doctor to discuss possible Lyme disease infection will also likely be costly, sometimes around $300 and that this may not be covered depending on their particular health insurance. In addition, some insurers will cover the costs of certain medications but not others, which may adversely affect the treatment of Lyme disease should it be diagnosed. When ordering Lyme disease tests it is important to ensure that the laboratory chosen is licensed by the Centers for Medicare and Medicaid (CMS) in the US and, if it is in California, New York, Pennsylvania, Maryland, or Florida, that it has the appropriate state-specific licenses. Other testing laboratories are available aside from IgeneX and Immunosciences, but these appear to be the most widely used by patients applying for Lyme disease testing in the US. Alternative laboratory facilities may be used by specific local health authorities and the Lyme disease test cost will differ between facilities.
(costs based on previous years, contact the company for current pricing.)
(prices are taken from their online catalog, as of May 2011, contact the company for current pricing.)
ELISA test for Borrelia burgdorferia IgM and IgG – $100
Western blot for B. burgdorferi IgM and IgG – $120
Immunoserology Lyme Panel A by ELISA (IgG and IgM against tick-borne antigens) – $450
Immunoserology Lyme Panel B by ELISA and Western blot (IgG and IgM against tick-borne antigens) – $550