--- title: Homocysteine Test type: test id: homocysteine url: "https://www.test-well.com/tests/homocysteine" price_usd: 27.99 lab_fee_usd: 6 all_in_usd: 33.99 cpt: 83090 category: Heart Health sample: Blood draw fasting_required: true results_in: "2–5 business days" labs: - Quest - Labcorp - BioReference orderable: true reviewed_at: 2026-09-14 order_url: "https://www.test-well.com/cart?add=homocysteine&utm_source=ai_agent&utm_medium=markdown" --- # Homocysteine Test > Elevated homocysteine is linked to heart disease, stroke, and B-vitamin deficiency, measured from a standard blood draw. At TestWell it costs $27.99 plus a $6 lab fee, requires an 8–12 hour fast, and results post in 2–5 business days. Physician-authorized with no doctor's visit or insurance needed; draw at Quest or Labcorp. ## Key facts | Fact | Value | | --- | --- | | Price | $27.99 + $6 lab processing fee per order ($33.99 all-in for this test alone) | | CPT code | 83090 | | Sample | Blood draw | | Fasting | Yes — 8–12 hours | | Results | 2–5 business days | | Labs | Quest Diagnostics, Labcorp, BioReference (NY & NJ) | | Biomarkers measured | 1 | | Physician authorization | Included — no doctor's visit, referral or insurance needed | | Payment | Card, HSA or FSA; cash-pay only (no insurance billing) | ## What does the Homocysteine test tell you? Elevated homocysteine is linked to heart disease, stroke, and B-vitamin deficiency. Homocysteine is an amino acid that, when elevated, is associated with an increased risk of heart disease, stroke, and blood clots. High levels may indicate a deficiency in vitamin B12, B6, or folate. It can also be elevated due to genetics (MTHFR gene variants), kidney disease, or certain medications. **Clinical use:** Amino acid byproduct of methionine metabolism. Elevated homocysteine is associated with cardiovascular disease, dementia, and pregnancy complications; often correctable with B-vitamin supplementation. ## Who should order it? Anyone with family history of early cardiovascular disease, unexplained miscarriage or fertility issues, MTHFR gene variant carriers, or low B12/folate intake. ## Biomarkers measured - [Homocysteine](https://www.test-well.com/biomarkers/homocysteine) ## Price by lab | Lab | Test price | All-in (with $6 fee) | Notes | | --- | --- | --- | --- | | Quest Diagnostics | $27.99 | $33.99 | Choose at checkout; walk-in patient service centers nationwide (not NY/NJ) | | Labcorp | $28.99 | $34.99 | Choose at checkout; walk-in patient service centers nationwide (not NY/NJ) | | BioReference (NY & NJ) | $32.99 | $38.99 | New York and New Jersey orders route here automatically | Rhode Island is not served. Prices are identical online and in the lab; no draw fee or physician fee is added. ## How much does a Homocysteine test cost? A Homocysteine test costs $27.99 at TestWell — $33.99 all-in when ordered alone, because the $6 lab processing fee is charged once per order, with no draw fee or physician fee added. Ordered directly from the labs' own consumer sites, the same test lists at $75.00 at Quest Health and $79.00 at Labcorp OnDemand (list prices checked Sep 12, 2026). Hospital outpatient labs typically bill around $130.00 self-pay for the same test, and often more. With insurance, what you pay depends on your deductible and your plan's negotiated rate; TestWell's price is fixed before the draw and is HSA/FSA-eligible. | Where you order | Price | One test, all-in | Notes | | --- | --- | --- | --- | | TestWell (drawn at Quest or Labcorp) | $27.99 | $33.99 | Includes the one $6 lab processing fee, charged once per order | | Quest Health (Quest Diagnostics' own site) | $75.00 | $75.00 | [list price checked 2026-09-12](https://www.questhealth.com/product/homocysteine-test/31789M.html) | | Labcorp OnDemand (Labcorp's own site) | $79.00 | $79.00 | [list price checked 2026-09-12](https://www.ondemand.labcorp.com/lab-tests/homocysteine-test) | | Hospital outpatient lab, self-pay (typical) | $130.00 | $130.00 | Reference figure; hospital charges vary widely by facility and are often higher | Lab test codes: Quest test code 31789 · Labcorp test no. 706994 · BioReference code 1311-0. ## How do you prepare? Fasting for 8–12 hours recommended. Water is okay. ## Related conditions - [Cardiovascular disease risk](https://www.test-well.com/conditions/heart-disease-risk) - Hyperhomocysteinemia (E72.11) - B12 deficiency (E53.8) - Folate deficiency (E53.8) ## Is the Homocysteine worth it? > Worth it in two situations: investigating cardiovascular risk beyond the standard lipid panel, and checking whether your B-vitamin status is FUNCTIONALLY adequate - homocysteine rises when B12, folate, or B6 aren't doing their job, sometimes before blood vitamin levels look abnormal. $27.99, one fasting draw. ### Worth it if you… - Family history of early heart disease or stroke where you want the fuller risk picture alongside lipids and hs-CRP - Suspected B12 or folate deficiency with borderline-normal vitamin levels - homocysteine shows the functional shortfall - MTHFR variant carriers checking whether the variant is actually affecting their folate metabolism in practice - Vegans and vegetarians auditing whether supplementation is keeping up (B12 especially) ### You can probably wait if you… - You want a general 'inflammation' number - that's [hs-CRP ($34.99)](https://www.test-well.com/tests/hs-crp), a different marker answering a different question - You already know you're B12 deficient - treat and retest the B12; homocysteine adds little once the deficiency is established - You're expecting it to guide supplement DOSES - it flags a problem and confirms correction on retest; dosing is a you-and-your-provider decision ### At home or in the lab? At-home collection is not recommended for this test. Venous draw at Quest or Labcorp. Fasting 10-12 hours is recommended for a clean baseline. $27.99 self-pay versus $45 at consumer competitors; results in 2-5 business days. ### How do you read the results? | Result | Typical adult range | What an out-of-range value can mean | | --- | --- | --- | | Homocysteine | ~5-15 µmol/L (labs vary) | Mildly elevated levels most often point to functional B12/folate/B6 shortfall (very treatable) or kidney function, and are associated with higher cardiovascular risk. The common path: replete the B vitamins, retest in 2-3 months, and watch it fall. Persistently high despite good B-vitamin status is worth reviewing with a clinician. | _This section medically reviewed; last reviewed 2026-08-04._ ## Common questions about the Homocysteine test ### What's a normal homocysteine level? Most labs report normal as 5-15 µmol/L, but optimal for cardiovascular and cognitive health is closer to 7-9 µmol/L. Above 15 µmol/L is hyperhomocysteinemia and warrants B-vitamin investigation. Above 100 µmol/L (rare) is severe and requires specialist evaluation. ### What causes elevated homocysteine? Low B12, folate, or B6 intake (the three vitamins that metabolize homocysteine). Genetic MTHFR variants. Kidney disease. Hypothyroidism. Certain medications (metformin, methotrexate, PPIs). Most cases respond well to a methylated B-complex within 8-12 weeks. ### How does high homocysteine raise heart risk? Homocysteine damages the inner lining of blood vessels and accelerates atherosclerosis. Elevated levels also raise stroke risk independent of cholesterol. Lowering homocysteine with B vitamins improves vascular markers, though the effect on hard outcomes (heart attacks) is modest in trials. ### How much does a homocysteine test cost without insurance? On TestWell, Homocysteine is $27.99. Quest Direct lists the same test at $45, walk-in hospital labs typically bill $100-130 without insurance. ### What is the CPT code for homocysteine? The CPT code for serum homocysteine is 83090. ### Do I need to fast for a homocysteine test? Yes — 8-12 hour fast (water only). Recent meals (especially methionine-rich foods like meat) can transiently elevate homocysteine and produce a false-positive. ### Should I add B12 and folate to my order? Yes if homocysteine is elevated and you want to know the cause. The pattern of low [B12](https://www.test-well.com/tests/vitamin-b12) + low folate + high homocysteine points to nutritional deficiency. Add MTHFR genetic testing if you have a strong family history of cardiovascular disease. ### How much does a homocysteine test cost? $27.99 self-pay on TestWell at Quest or Labcorp, versus $45 at consumer competitors and $100+ clinic-billed. HSA/FSA eligible. ### Homocysteine vs hs-CRP - which heart-risk test should I get? They answer different questions and are often drawn together: hs-CRP measures vascular INFLAMMATION, homocysteine measures a metabolic risk factor tied to B-vitamin status. If you're building a beyond-lipids cardiac picture, the pair (plus ApoB) is the informative trio. ### I have an MTHFR variant - does this test matter for me? It's the practical check. MTHFR variants are extremely common and often functionally silent - homocysteine tells you whether YOUR folate metabolism is actually keeping up. A normal homocysteine with an MTHFR variant is reassuring; an elevated one gives you and your provider something concrete to correct and retrack. ### Do I need to fast? Yes - 10-12 hours is the standard recommendation for homocysteine (a recent protein-heavy meal can nudge it). Water and black coffee are fine. Morning draws make the fast painless. ## How to order 1. Add to cart: https://www.test-well.com/cart?add=homocysteine&utm_source=ai_agent&utm_medium=markdown 2. Create an account or sign in, confirm your state and preferred lab, pay by card, HSA or FSA. 3. A licensed physician authorizes the order (usually within minutes); the requisition arrives by email. 4. Walk into any Quest Diagnostics, Labcorp, BioReference (NY & NJ) patient service center — no appointment needed at most sites. 5. Results post to your TestWell portal in 2–5 business days with reference ranges and flags. ## Related - [Advanced Heart Health Blood Tests: Beyond Cholesterol](https://www.test-well.com/guides/advanced-heart-health-blood-tests) - [Comprehensive B12 Deficiency Panel](https://www.test-well.com/tests/b12-deficiency-panel) — 3 tests · $79.99 - [Inflammation Panel](https://www.test-well.com/tests/inflammation-panel) — 7 tests · $119.99 - [Longevity & Anti-Aging Panel](https://www.test-well.com/tests/longevity-panel) — 13 tests · $239.99 - [Advanced Cholesterol Particle Test (NMR)](https://www.test-well.com/tests/nmr-lipoprofile) — $70.99 - [ApoB — Heart Attack Risk Predictor](https://www.test-well.com/tests/apolipoprotein-b) — $30.99 - [ApoE Genotype (Cardiovascular Risk)](https://www.test-well.com/tests/apoe-genotype-cardio) — $133.99 - [Fibrinogen Activity](https://www.test-well.com/tests/fibrinogen-test) — $22.99 - [Lp(a) Hereditary Heart Risk Test](https://www.test-well.com/tests/lipoprotein-a) — $34.99 - [All Heart Health tests](https://www.test-well.com/tests/category/heart-health) - [Full test directory](https://www.test-well.com/tests/directory) --- Medically reviewed by Youmna DiStefano, MD (Medical Reviewer, TestWell); last reviewed 2026-09-14. Review policy: https://www.test-well.com/reviewers/youmna-distefano-md Canonical page: https://www.test-well.com/tests/homocysteine Machine-readable catalog: https://www.test-well.com/api/catalog.json · MCP server: https://www.test-well.com/mcp · Overview for agents: https://www.test-well.com/llms.txt Prices are cash-pay, in USD, and include physician authorization; every order adds one flat $6 lab processing fee. Educational content is not a diagnosis — discuss results with a clinician.