Tuberculosis (TB) testing screens for the presence of the Mycobacterium tuberculosis bacteria, which causes infection that can lead to TB disease. The cost of a TB test varies significantly based on where it is administered, the type of test performed, and the reason for testing. Pricing ranges from completely free at certain public health facilities to a substantial out-of-pocket expense at private clinics.
Understanding the Different Types of TB Tests
Two main methods screen for tuberculosis infection: the Tuberculin Skin Test (TST) and the Interferon-Gamma Release Assays (IGRA), also known as a TB blood test. The TST, often called the Mantoux or PPD test, involves injecting a small amount of purified protein derivative (PPD) under the skin on the forearm. A healthcare professional must check the injection site 48 to 72 hours later to measure the reaction, requiring two separate visits.
The IGRA is a modern alternative requiring only a single visit for a simple blood draw. This test measures the release of interferon-gamma by white blood cells after mixing them with specific TB-related antigens in a laboratory setting. Because the IGRA does not rely on a visual skin reaction, it is the preferred test for people who have received the Bacille Calmette-Guérin (BCG) vaccine, which can cause a false-positive result on the TST.
Accessing Free and Low-Cost TB Testing
Testing for tuberculosis is often available at no cost or for a reduced fee through government-funded channels, particularly for high-risk individuals. Local public health departments and county clinics are the primary source for free TB testing, especially for those who have had close contact with an infected person or meet high-risk criteria. Some city health departments offer both skin and blood tests to adults and children without requiring insurance.
Federally Qualified Health Centers (FQHCs), also known as Community Health Centers (CHCs), are another reliable source for low-cost testing. These centers receive federal funding to provide services regardless of a patient’s insurance status or ability to pay. FQHCs typically offer a sliding fee scale, adjusting the cost based on the patient’s household income and family size.
In some situations, the cost is absorbed by the institution requiring the test, making it free to the individual. For example, testing mandated for certain healthcare workers or new employees in educational settings is sometimes covered by the employer. However, some employers or school districts may require the applicant to pay the initial cost, even if the test is a prerequisite for employment.
Factors Influencing Test Pricing
When testing is not covered by a public program, the final out-of-pocket price is subject to several variables. The type of test is a major determinant of cost; the blood test (IGRA) is typically more expensive than the skin test (TST) due to required laboratory processing. While the TST is generally less costly to administer, the IGRA’s single-visit requirement can sometimes make its total cost comparable when factoring in staff time for two patient visits.
The choice of provider also impacts the price, as private physician offices and urgent care centers generally charge more than public clinics. For instance, the cash price for a TST at an urgent care center or pharmacy might range from $25 to $65, while the IGRA blood test can cost substantially more. If a patient has private health insurance, the test is usually covered, but the patient may still be responsible for a co-pay, deductible, or co-insurance amount determined by their specific plan.
What Happens After Testing
A positive result from either a TST or an IGRA indicates the Mycobacterium tuberculosis bacteria is present in the body, but it does not differentiate between a latent infection and active TB disease. A latent infection means the bacteria are inactive and not causing symptoms, while active disease means the person is sick and can transmit the bacteria to others. The positive screening result serves as a trigger for immediate follow-up diagnostic evaluations.
The healthcare provider will next order a chest X-ray to check for visible lung abnormalities, such as infiltrates or lesions, which are often signs of active TB disease. If the chest X-ray is abnormal or if the patient reports symptoms like a persistent cough, fever, or night sweats, a sputum sample may be collected for further laboratory analysis. These additional tests are necessary to confirm an active infection and to guide the appropriate treatment plan.