Cash-Pay Lab Billing by State
Start with your state, then compare the billing workflows New Century Labs supports.
New Century Labs supports all three billing workflows: Direct PayService FeeSelf-Managed Pricing
Educational overview, not legal advice · Last reviewed July 2026 · Choose a starting point here, then confirm it with counsel.
38Limitlessall other states
6TransparentAZ · CT · LA · MD · PA · TX
4PurposefulCA · MI · OR · WA
3EffortlessNJ · NY · RI
AKMEVTNHWAIDMTNDMNILWIMINYMARIORNVWYSDIAINOHPANJCTCAUTCONEMOKYWVVAMDDEAZNMKSARTNNCSCDCOKLAMSALGAHITXFL
Which New Century Labs workflow works where
| State rule | Direct PayPatient pays New Century Labs directly for lab testing | Service FeeClinic adds a transparent fee for professional/admin services | Self-Managed PricingClinic controls patient pricing where state law allows |
|---|---|---|---|
| Limitless38 states incl. FL & DC | Yes | Yes | Yes |
| TransparentAZ · CT · LA · MD · PA · TX | Yes | Yes | Yes, but the margin must be visible on the invoice |
| PurposefulCA · MI · OR · WA | Yes | Yes | Not permitted |
| EffortlessNJ · NY · RI | Yes | Not permitted | Not permitted |
Scroll the table sideways to see all three workflows.
Cash-pay lab pricing your practice knows before orderingTransparent pricing, no surprise bills, and Direct Pay, Service Fee, or Self-Managed billing.
See how pricing works Every state supports at least one New Century Labs workflow — darker shading means state rules leave less room. A simplified summary, not legal advice: open a state guide for specifics and confirm the fit with counsel. States without a guide yet are shaded but not linked.
Plain-English answer
Lab billing rules differ by state, so the right workflow differs too. Start with your state guide below, or start from the national guide.
Lab billing rules differ by state, so the right workflow differs too. Each state guide below gives a plain-English answer, a recommended starting workflow, and the state-specific rules to review with counsel.
State guideAlabamaDirect Pay, Service Fee, or Self-Managed: what fits Alabama practices, and where to start.State guideAlaskaDirect Pay, Service Fee, or Self-Managed: what fits Alaska practices, and where to start.State guideArkansasDirect Pay, Service Fee, or Self-Managed: what fits Arkansas practices, and where to start.State guideCaliforniaCalifornia caps what a clinic may charge for an outside lab’s test at what the lab charged (B&P §655.5) — Direct Pay or a disclosed Service Fee; markup is not permitted.State guideColoradoDirect Pay, Service Fee, or Self-Managed: what fits Colorado practices, and where to start.State guideConnecticutDirect Pay, Service Fee, or Self-Managed: what fits Connecticut practices, and where to start.State guideDelawareDirect Pay, Service Fee, or Self-Managed: what fits Delaware practices, and where to start.State guideFloridaDirect Pay, Service Fee, or Self-Managed: what fits Florida practices, and where to start.State guideGeorgiaDirect Pay, Service Fee, or Self-Managed: what fits Georgia practices, and where to start.State guideHawaiiDirect Pay, Service Fee, or Self-Managed: what fits Hawaii practices, and where to start.State guideIdahoDirect Pay, Service Fee, or Self-Managed: what fits Idaho practices, and where to start.State guideIllinoisDirect Pay, Service Fee, or Self-Managed: what fits Illinois practices, and where to start.State guideIndianaDirect Pay, Service Fee, or Self-Managed: what fits Indiana practices, and where to start.State guideIowaDirect Pay, Service Fee, or Self-Managed: what fits Iowa practices, and where to start.State guideKansasDirect Pay, Service Fee, or Self-Managed: what fits Kansas practices, and where to start.State guideKentuckyDirect Pay, Service Fee, or Self-Managed: what fits Kentucky practices, and where to start.State guideLouisianaDirect Pay, Service Fee, or Self-Managed: what fits Louisiana practices, and where to start.State guideMaineMaine has no statute restricting lab rebilling: all three billing workflows are open to Maine clinics.State guideMarylandDirect Pay, Service Fee, or Self-Managed: what fits Maryland practices, and where to start.State guideMassachusettsDirect Pay, Service Fee, or Self-Managed: what fits Massachusetts practices, and where to start.State guideMichiganDirect Pay, Service Fee, or Self-Managed: what fits Michigan practices, and where to start.State guideMinnesotaDirect Pay, Service Fee, or Self-Managed: what fits Minnesota practices, and where to start.State guideMississippiDirect Pay, Service Fee, or Self-Managed: what fits Mississippi practices, and where to start.State guideMissouriDirect Pay, Service Fee, or Self-Managed: what fits Missouri practices, and where to start.State guideMontanaDirect Pay, Service Fee, or Self-Managed: what fits Montana practices, and where to start.State guideNebraskaDirect Pay, Service Fee, or Self-Managed: what fits Nebraska practices, and where to start.State guideNevadaDirect Pay, Service Fee, or Self-Managed: what fits Nevada practices, and where to start.State guideNew HampshireDirect Pay, Service Fee, or Self-Managed: what fits New Hampshire practices, and where to start.State guideNew JerseyDirect Pay, Service Fee, or Self-Managed: what fits New Jersey practices, and where to start.State guideNew MexicoDirect Pay, Service Fee, or Self-Managed: what fits New Mexico practices, and where to start.State guideNew YorkDirect Pay, Service Fee, or Self-Managed: what fits New York practices, and where to start.State guideNorth CarolinaDirect Pay, Service Fee, or Self-Managed: what fits North Carolina practices, and where to start.State guideNorth DakotaDirect Pay, Service Fee, or Self-Managed: what fits North Dakota practices, and where to start.State guideOhioDirect Pay, Service Fee, or Self-Managed: what fits Ohio practices, and where to start.State guideOklahomaDirect Pay, Service Fee, or Self-Managed: what fits Oklahoma practices, and where to start.State guideOregonOregon law does not allow a clinic to mark up an outside lab’s test (ORS 676.310) — Self-Managed Pricing is off the table, so Direct Pay or a transparent Service Fee is the workflow.State guidePennsylvaniaDirect Pay, Service Fee, or Self-Managed: what fits Pennsylvania practices, and where to start.State guideRhode IslandDirect Pay, Service Fee, or Self-Managed: what fits Rhode Island practices, and where to start.State guideSouth CarolinaDirect Pay, Service Fee, or Self-Managed: what fits South Carolina practices, and where to start.State guideSouth DakotaDirect Pay, Service Fee, or Self-Managed: what fits South Dakota practices, and where to start.State guideTennesseeDirect Pay, Service Fee, or Self-Managed: what fits Tennessee practices, and where to start.State guideTexasDirect Pay, Service Fee, or Self-Managed: what fits Texas practices, and where to start.State guideUtahDirect Pay, Service Fee, or Self-Managed: what fits Utah practices, and where to start.State guideVermontDirect Pay, Service Fee, or Self-Managed: what fits Vermont practices, and where to start.State guideVirginiaDirect Pay, Service Fee, or Self-Managed: what fits Virginia practices, and where to start.State guideWashingtonWashington law bars profiting on purchased lab services (RCW 19.68) — Self-Managed Pricing is not available, so Direct Pay or a Service Fee for the clinic’s own services is the workflow.State guideWashington DCDirect Pay, Service Fee, or Self-Managed: what fits Washington DC practices, and where to start.State guideWest VirginiaDirect Pay, Service Fee, or Self-Managed: what fits West Virginia practices, and where to start.State guideWisconsinDirect Pay, Service Fee, or Self-Managed: what fits Wisconsin practices, and where to start.State guideWyomingDirect Pay, Service Fee, or Self-Managed: what fits Wyoming practices, and where to start.
More states on the way
More state guides are published as they are reviewed. If your state is not listed yet, start from the national guide, or walk through your state with our team on a call.
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Written by New Century Labs and reviewed for operational accuracy by the New Century Labs team — not reviewed as legal advice. Last reviewed July 2026; laws and payer rules may change. Confirm the right workflow for your practice with your healthcare counsel.
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Talk through the right cash-pay lab workflow for your practice.
Pick the workflow that fits your state and your practice. We’ll help you compare Direct Pay, Service Fee, and Self-Managed Pricing, then confirm it with counsel.