Almost nobody buys a TB test because they feel sick. They buy one because a nursing program, a hospital HR portal, a school district, or a staffing agency put a deadline on a form. That changes what “cheap” means: the lowest sticker price is not always the lowest total cost once you count the trips.
The classic tuberculin skin test is the cheapest test in this guide and the most expensive to schedule, because it takes two appointments and sometimes four. The blood tests cost more up front and take one visit. This guide prices both at every channel a self-pay patient can actually use, from county health departments to direct-to-consumer lab stores, and flags the fees people do not see coming.
What Does a TB Test Cost Without Insurance?
Seller and clinic prices below were read on September 4, 2026 from each organization’s own page. Medicare figures come from the CY2026 Quarter 3 Clinical Laboratory Fee Schedule, effective July 1, 2026, and from the CMS Physician and Other Practitioners file covering 2024 claims, released May 21, 2026.
| How you buy it | Low | Typical | High |
|---|---|---|---|
| Skin test (PPD/Mantoux, CPT 86580) at a county health department | $15 (Marion County, FL) | $25 (Salt Lake County) | $45 per visit (Dallas County) |
| TB blood test (IGRA) at a county health department | $55 (Dallas County) | $90 | $130 (Salt Lake County) |
| TB blood test bought direct from a lab store | $149 (Labcorp OnDemand, Walk-In Lab) | $149 | $155 (Quest, $149 plus its $6.00 physician fee) |
| Medicare benchmark, QuantiFERON-TB Gold Plus (CPT 86480, 2026 CLFS) | $61.98 | $61.98 | $61.98 |
| Medicare benchmark, T-SPOT.TB (CPT 86481, 2026 CLFS) | $100.00 | $100.00 | $100.00 |
| Average charge billed to Medicare, skin test 86580, office setting | $9.89 allowed | n/a | $29.12 submitted |
| Average charge billed to Medicare, blood test 86480, office setting | $60.57 allowed | n/a | $284.21 submitted |
| Two-step skin test sequence (two placements, two reads) | $30 | $50 | $90 (Dallas County at $45 per visit) |
| Positive result follow-up: evaluation plus chest X-ray | $80 (Dallas County comprehensive) | $80 | varies by facility |
Two things jump out. First, the three big direct-to-consumer lab sellers agree exactly: Quest, Labcorp OnDemand, and Walk-In Lab all list the QuantiFERON-TB Gold Plus at $149.00. That is a real market price, not an estimate, and it is your reference point for any quote you get.
Second, look at the gap between what a TB blood test is worth and what gets billed for it. Medicare’s 2026 lab fee schedule values the QuantiFERON at $61.98. On 2024 claims, providers submitted an average of $284.21 for that same code in office settings against an allowed amount of $60.57, roughly 4.7 times the negotiated rate. If a clinic quotes you $280 for a TB blood test, three national sellers will do it for $149.
How much is a TB test at a health department? $15 to $45 for the skin test and $55 to $130 for the blood test, which is the cheapest reliable channel in the country for this particular test.
What Drives the Price
Which test you get
There are three tests in play, and they are priced very differently. The tuberculin skin test (CPT 86580) is an intradermal injection read by eye. The QuantiFERON-TB Gold Plus (CPT 86480) and the T-SPOT.TB (CPT 86481) are blood tests, formally interferon-gamma release assays or IGRAs. Medicare pays $61.98 for the QuantiFERON and $100.00 for the T-SPOT, so even at the federal benchmark the T-SPOT is 61% more expensive.
The second visit nobody budgets for
Per the CDC, a TB skin test requires two visits with your health care provider: one to place it, one 48 to 72 hours later so a trained person can measure the reaction. Miss the 72-hour window and the CDC says the test has to be repeated from scratch. Dallas County prices its skin test at “$45 per visit,” which is the honest way to write it and the reason a $45 skin test is not always a $45 transaction.
Two-step testing for health care jobs
If you are being hired into a hospital, clinic, or long-term care setting, the CDC recommends two-step skin testing at baseline, meaning a second skin test placed 1 to 3 weeks after the first result is read. That is four appointments. The CDC also notes that a TB blood test used for baseline testing does not require two-step testing, which is why many nursing programs and hospital systems now just ask for the blood test even though it costs more per test.
A prior BCG vaccine
The CDC notes that the TB vaccine can cause a false-positive skin test reaction and that blood tests are preferred for people who received BCG. If you were vaccinated outside the United States, paying $149 for a blood test up front is usually cheaper than a $25 skin test that triggers a $80 chest X-ray workup.
Where you go
The channel spread on this test is enormous relative to its cost. A health department skin test is $15 to $45. An urgent care or occupational medicine clinic bills a visit charge on top of the test itself, which is the mechanism that turns a $25 test into a $200 bill. See urgent care cost without insurance for what that visit line runs. Notably, CVS MinuteClinic publishes out-of-pocket prices only for physicals and travel health services, so there is no posted cash TB price to compare against at the big retail clinics.
Cash Price vs. Insurance
At $15 to $155, a TB test sits far below any individual-market deductible. Running it through insurance mostly means adding a claim, a possible visit charge, and a wait, in exchange for applying a small negotiated amount toward a deductible you may never hit.
There is also a documentation problem specific to employment testing. Many employers and schools want a dated result on a specific form. A health department that does this all day will hand you paperwork built for exactly that purpose; a claims-based visit at a general clinic often will not, and you end up paying twice.
The real exposure for an uninsured patient is the submitted charge, not the test. Providers billed Medicare an average of $284.21 per office QuantiFERON on 2024 claims against $60.57 allowed. If a bill like that lands in your mailbox, you have a $149 published national retail price and a $61.98 federal benchmark to argue with. Ask for an itemized hospital bill so CPT 86480 shows on its own line, then work through how to negotiate medical bills with those two anchors.
How to Pay Less
Call the county health department first. This is the single biggest saving available on this page. Marion County, Florida charges $15. Tulsa charges $20 and waives the fee entirely for people who were exposed to an active case, are at increased risk, or have symptoms. Salt Lake County charges $25. Dallas County charges $45 per visit. That is a 10x range against a $149 retail blood test.
Ask whether the quoted fee covers the read. The phrasing matters. “Does the price include the follow-up visit to read it, or is that billed separately?” is a 15-second question that can save you a second charge. If you are being hired into health care and will need two-step testing, ask what the full sequence costs before you book the first placement.
Price the blood test as one visit, not one test. A $149 QuantiFERON that takes one trip can beat a $45-per-visit two-step skin test that takes four trips, once you count time off work and transport. Run any quote through our fair price checker before you agree to it.
Bundle it with the titers your school already asked for. If the same form requires proof of immunity, ordering everything at once spreads the flat per-order physician fee ($6.00 at both Quest and Walk-In Lab) and the blood draw across more tests. Labcorp OnDemand sells a combined pre-employment titers and TB screening product starting at $99.00. See titer test cost for the individual antigen prices and whether a titer beats re-vaccinating.
Use a community health center if you need the visit too. Federally qualified health centers run sliding-fee schedules that cover the encounter and routine testing at one income-based price. Start with free clinics and sliding-scale care.
Check the hospital’s posted cash rate before you accept a quote. If the only convenient option is a hospital-affiliated occupational health clinic, its machine-readable price file will list CPT 86580 and 86480 with a discounted cash price that is often far below the quoted rate. Hospital price transparency explains how to pull the file and find the code.
Which Test to Ask For
If you are paying cash and have no BCG history, the skin test at a health department is the cheapest route, provided you can make both appointments inside the 48 to 72 hour window. If you were vaccinated abroad, if you cannot reliably return for the read, or if your employer requires two-step baseline testing, the blood test at $149 is usually the better buy despite the higher sticker.
Either way, confirm what your employer or program will actually accept before you pay. TB testing is one line on a longer occupational health checklist that often also includes a DOT physical for driving roles, a drug test, an immigration medical exam for green card applicants, or a sports physical for student athletes. Pricing the whole list at one clinic is almost always cheaper than chasing each item separately, and if a positive TB result sends you for imaging, X-ray cost without insurance and blood work cost without insurance cover what comes next.