A TSH-only screen runs $19 to $49 at direct-pay labs. A clinically complete thyroid panel — TSH, Free T4, Free T3, TPO antibodies, and thyroglobulin antibodies — costs $99 to $179. Here's what each major online lab service charges and which panel actually catches what.
Updated: April 22, 2026 • Prices verified April 2026, subject to change
The Cost Gap
Thyroid testing is one of the most common lab orders in the country — and one of the most variable in price. A simple TSH test costs the reference lab a few dollars to run. At a hospital, uninsured patients routinely see it billed at $100 to $300. At a doctor's office, the same test plus the visit fee pushes past $250. Direct-pay online lab services list TSH for $19 to $49 and a full 5-marker panel for $99 to $179. Same Quest Diagnostics or LabCorp analyzer, very different price tag.
The bigger issue isn't cost — it's what you're actually buying. A "$10 TSH test" sounds great until you realize it catches only the end-stage cases where the gland is already clearly failing. Subclinical hypothyroidism, early Hashimoto's, and T4-to-T3 conversion problems routinely show normal TSH for years. If you have symptoms, the cheap screen is the test most likely to send you home falsely reassured.
This guide breaks down what each tier of thyroid testing actually costs, what it covers, and who should pay the extra for the full panel.
Rule of thumb: TSH-only is a screen. If you have no symptoms and want a routine check, it's fine. If you have symptoms — fatigue, unexplained weight change, cold sensitivity, hair thinning, brain fog — TSH alone is the wrong test to start with.
2026 Price Comparison
Prices reflect direct-pay cash prices as listed by each provider in April 2026. Draw fees of $6–$10 may be separate at some services. Coverage of antibody markers varies — only panels that include TPO and thyroglobulin antibodies are "clinically complete."
| Provider | Test / Panel | Price | Collection | Turnaround |
|---|---|---|---|---|
| RequestATest | TSH Only | $29–$39 Best | In-lab (Quest / LabCorp) | 1–3 business days |
| RequestATest | Thyroid Panel (TSH + Free T4 + Free T3) | $69–$99 | In-lab (Quest / LabCorp) | 1–3 business days |
| RequestATest | Full Thyroid Panel (TSH, FT4, FT3, TPO, TgAb) | $119–$159 Best full | In-lab (Quest / LabCorp) | 1–3 business days |
| HealthLabs | TSH Only | $29–$49 | In-lab (Quest) | 1–3 business days |
| HealthLabs | Comprehensive Thyroid Panel | $129–$179 | In-lab (Quest) | 1–3 business days |
| WalkInLab | TSH Only | $35–$49 | In-lab (Quest / LabCorp) | 1–3 business days |
| WalkInLab | Comprehensive Thyroid Panel | $139–$179 | In-lab (Quest / LabCorp) | 2–5 business days |
| Ulta Lab Tests | TSH Only | $19–$29 Lowest TSH | In-lab (Quest) | 1–3 business days |
| Ulta Lab Tests | Thyroid Panel (TSH, FT4, FT3, TPO, TgAb) | $99–$149 | In-lab (Quest) | 1–3 business days |
| EverlyWell | Thyroid Test (TSH, FT3, FT4, TPO) | $99–$149 | At-home finger-prick kit | 5–7 days after sample return |
| LabCorp OnDemand | TSH Only | $49–$69 | In-lab (LabCorp) | 1–3 business days |
| LabCorp OnDemand | Thyroid Panel (TSH, FT4, FT3) | $99–$129 | In-lab (LabCorp) | 1–3 business days |
| QuestDirect | TSH Only | $45–$65 | In-lab (Quest) | 1–3 business days |
| QuestDirect | Thyroid Panel with Antibodies | $139–$179 | In-lab (Quest) | 1–3 business days |
| MyLab Positive | Reverse T3 (add-on) | $49–$79 | In-lab (Quest) | 2–5 business days |
| Prices verified April 2026, subject to change. "Full" panels include TSH + Free T4 + Free T3 + TPO antibodies + thyroglobulin antibodies. Panels without antibodies don't catch autoimmune thyroid disease. | ||||
Want a clinically complete thyroid panel at the lowest price? RequestATest's Full Thyroid Panel ($119–$159) includes TSH, Free T4, Free T3, and both antibody markers.
Check Thyroid Panel Prices at RequestATestWhich Panel To Order
The single biggest decision on your thyroid order isn't which lab service to use — it's how many markers you include. Here's what each tier measures and where the blind spots are.
TSH is the pituitary's signal to your thyroid. When thyroid hormone levels drop, the pituitary releases more TSH to push the gland harder; when thyroid hormone is abundant, TSH falls. It's a sensitive early-warning system and catches most overt hypo- and hyperthyroidism. What it misses: subclinical hypothyroidism where Free T4 is low but TSH compensates before rising out of range; early autoimmune thyroiditis where TPO antibodies are elevated years before TSH budges; and secondary hypothyroidism from pituitary dysfunction, where TSH stays low despite low thyroid output.
Adds the two main thyroid hormones. Free T4 is the storage form; Free T3 is the biologically active form. This combination is sufficient for most routine evaluations and is what many endocrinologists order as a baseline when symptoms are present. What it still misses: autoimmune thyroid disease, because antibodies aren't included.
Adds thyroid peroxidase (TPO) antibodies and thyroglobulin (TgAb) antibodies. Hashimoto's thyroiditis — the most common cause of hypothyroidism in the U.S. — is diagnosed by elevated TPO and/or TgAb. Because antibody elevations frequently precede clinical thyroid disease by years, this is the only panel that catches early autoimmune patterns. If you have hypothyroid symptoms, a family history of thyroid disease, or any other autoimmune condition, this is the panel to order.
Reverse T3 is a metabolically inactive form the body produces when it wants to "brake" thyroid activity — during acute illness, prolonged calorie restriction, or chronic stress. Elevated Reverse T3 with normal Free T4 and low Free T3 suggests a conversion problem rather than primary thyroid dysfunction. It's not a first-line test. Order it if you have persistent hypothyroid symptoms despite normal standard labs, or if you suspect "low T3 syndrome" from extended dieting or chronic stress.
Warning about cheap TSH-only tests: A $10–$25 TSH-only screen feels like a win on price but can send you home with a confident "your thyroid is fine" based on one marker. Subclinical hypothyroidism affects an estimated 4–10% of adults and is missed entirely by TSH-only testing. Early Hashimoto's commonly presents as elevated antibodies with normal TSH for years. If you have symptoms, the price difference between TSH-only and a full panel is $50–$120 — a lot cheaper than the wasted months spent chasing the wrong diagnosis.
Buyer Profiles
Four common profiles we hear from, and which tier matches each.
No symptoms, no family history, annual check-up curiosity. A TSH-only test is appropriate. Expected cost: $19–$49. Retest every 2–3 years unless something changes.
Fatigue, weight changes, cold hands, hair thinning, brain fog — but the TSH came back normal and your doctor said "thyroid is fine." Order the full panel with antibodies. Expected cost: $99–$179. This is the single most common scenario where direct-pay testing finds something a standard workup missed.
Thyroid disease runs in the family, or you already have another autoimmune condition (celiac, type 1 diabetes, rheumatoid arthritis, vitiligo). Go straight to the full panel with antibodies. Expected cost: $99–$179. Retest every 12 months because antibody trajectory matters.
Diagnosed hypothyroidism on replacement therapy. Standard monitoring is TSH + Free T4 every 6–12 months (6–8 weeks after dose changes). A Thyroid Panel ($69–$99) covers this without paying for antibodies you don't need to retest repeatedly.
Reading Your Results
Reference ranges vary between labs. What follows is a general framework, not a diagnosis.
Standard reference: 0.4–4.0 mIU/L. Many endocrinologists consider 1.0–2.5 mIU/L "optimal." TSH above 4.5 mIU/L with normal Free T4 suggests subclinical hypothyroidism. TSH above 10 mIU/L is overt hypothyroidism regardless of T4. TSH below 0.4 mIU/L suggests hyperthyroidism, which requires Free T4 and Free T3 for confirmation.
Standard reference: 0.8–1.8 ng/dL. Low-normal Free T4 with high-normal TSH is a pattern consistent with early hypothyroidism even if both numbers are technically "in range."
Standard reference: 2.3–4.2 pg/mL. Low Free T3 with normal Free T4 suggests a conversion problem — worth pairing with Reverse T3 if persistent.
Reference: typically below 34–35 IU/mL. Elevated TPO antibodies are the hallmark of Hashimoto's thyroiditis. Antibody elevation frequently precedes overt thyroid failure by years, so an elevated TPO with normal TSH is a diagnostic finding on its own, not a false positive.
Reference: typically below 4.0 IU/mL. Often elevated alongside TPO in autoimmune thyroiditis. Some patients show elevated TgAb only, so ordering both antibodies catches more cases than either alone.
This section is a reading aid, not medical advice. If your results are abnormal, discuss them with a licensed clinician.
Retest Cadence
Ready to order? RequestATest's Full Thyroid Panel covers TSH, Free T4, Free T3, TPO, and thyroglobulin antibodies in a single draw.
Browse Thyroid Panels at RequestATestCommon Questions
A TSH-only screen runs $19–$49 at direct-pay labs. A full thyroid panel (TSH, Free T4, Free T3, TPO, TgAb) costs $99–$179. Reverse T3 is a $45–$79 add-on. The same tests through a doctor's office for uninsured patients often bill at $150–$400 before the office visit fee.
TSH-only is fine for routine asymptomatic screening. If you have symptoms — fatigue, weight changes, cold intolerance, hair thinning, brain fog — TSH alone is the wrong test. Subclinical hypothyroidism, early Hashimoto's, and T4-to-T3 conversion problems can all show normal TSH for years. Order the full panel with antibodies if you're symptomatic.
A clinically complete panel includes: TSH, Free T4, Free T3, TPO antibodies, and thyroglobulin antibodies. Some services sell a "thyroid panel" that omits antibodies — those panels can't rule out Hashimoto's or Graves'. Read the description before ordering.
Not for routine screening. It's useful when you have persistent hypothyroid symptoms despite normal standard labs, or if you suspect a conversion issue from chronic stress or extended dieting. Treat it as an optional add-on, not a first-line test.
Because "normal TSH" isn't the same as "healthy thyroid." Subclinical hypothyroidism affects 4–10% of adults and shows normal TSH. Early autoimmune thyroiditis shows elevated antibodies with normal TSH for years. If you have symptoms, a cheap TSH-only test is the most likely way to get falsely reassured. Spend the extra $50–$120 on a panel that actually answers the question.
Healthy adults with no symptoms: every 2–3 years, annually after 50. Hashimoto's or subclinical hypothyroidism: every 6–12 months. On levothyroxine: 6–8 weeks after a dose change, then every 6–12 months once stable. During pregnancy: every trimester.
A clinically complete thyroid panel costs less than a single doctor's office visit and catches autoimmune thyroid disease the cheap TSH-only test can't see.
Browse Thyroid Panels at RequestATestFull panel from $119 • 4,000+ draw stations • Results in 1–3 days
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