NEWCENTURYLABSEST. 2014

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 ruleDirect PayPatient pays New Century Labs directly for lab testingService FeeClinic adds a transparent fee for professional/admin servicesSelf-Managed PricingClinic controls patient pricing where state law allows
Limitless38 states incl. FL & DCYesYesYes
TransparentAZ · CT · LA · MD · PA · TXYesYesYes, but the margin must be visible on the invoice
PurposefulCA · MI · OR · WAYesYesNot permitted
EffortlessNJ · NY · RIYesNot permittedNot 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.

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Copy the snippet to embed the live map. It stays current as laws change: we re-check every state monthly. Attribution link included; keep it intact.

Cite: “Cash-Pay Lab Billing by State,” New Century Labs, 2026-07-23. https://newcenturylabs.com/cash-pay-lab-billing/states/

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 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 guideFloridaDirect Pay, Service Fee, or Self-Managed: what fits Florida practices, and where to start.State guideIllinoisDirect Pay, Service Fee, or Self-Managed: what fits Illinois 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 guideMichiganDirect Pay, Service Fee, or Self-Managed: what fits Michigan 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 YorkDirect Pay, Service Fee, or Self-Managed: what fits New York 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 guideTexasDirect Pay, Service Fee, or Self-Managed: what fits Texas 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.

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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We re-check every state’s statutes monthly. One short email when something changes: no newsletter, no marketing list.

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.

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