Thiopurine Metabolites test covered by insurance?

Any of you get this test done in the usa? My gastroenterologist wants me to get a Thiopurine Metabolites blood test done, CPT code 82542. I'm wandering through the typical labyrinth of will this be covered?, how much will it cost me out of pocket?, long waits on the phone, and usual dodges and half answers by insurance...ugh.

Seems it matters who draws the blood and also who processes it (if not done onsite). Ideally, I gotta do it through quest diagnostics. Here's a link to their description of that test: www.questdiagnostics.com/testcenter/TestDetail.action?ntc=91745

My insurance always covered it. You have to call your insurance company and ask.

Insurance companies suck. i hate them.

I'm going to drop by quest diagnostics labs during lunchbreak and ask them who processes it, where it's shipped, and cost. Phoning them was impossible wait times.

I stopped by quest diagnostics, and they said it's a total of $114.40 for the Thiopurine Metabolites test, should my insurance not cover it. Quest does this test (draws the blood and also runs it through their lab for diagnosis),so, I am reasonably assured that my insurance will cover it in full *pheew*. No need for Prometheus labs...

Glad you finally got a straight answer!

I had the test done by Prometheus and wanted to include the info here in case it may help anyone else. I called the billing department at Prometheus ((888) 892-8391) and spoke with a woman who was incredibly helpful and patient. I'm not remembering the exact numbers, but these are close:

Full cost of the test: $385

If you make less than a certain amount per year, Prometheus will discount the price:
$275 if you make less than ??? $56,000?
$175 if you make less than $44,000
$75 if you make less than ???

CPT for Prometheus Thiopurine Metablolites is 82491 found here:
http://www.prometheuslabs.com/Resources/PTM/Thiopurine_Metabolites_Product_Detail.pdf

Insurance may pay different amount depending on whether Prometheus Labs is in network or out of network. I suspect they are out of network for most insurance and that was the case for me. For out of network, my insurance looked up what they call a "reasonable and customary fee" based on the zip code or tax ID of the lab (Prometheus Tax ID# 33-0685754 NPI# 1073642641). My insurance said they would pay $110.

When I told Prometheus this, they said that in that case, when the Dr's office billed them, they would discount anything above $110 as long as the insurance did not apply any co-pays or deductibles. I don't quite understand that last part so I'm still waiting to see exactly what it will cost me, but in my case I went ahead and got the test because I knew my cost wouldn't be any more than $65 based on my income.

Lab requisition form is here if your doctor is not familiar with Prometheus:
http://www.prometheuslabs.com/Resources/Physician/Test_Request_Webform.pdf