Also known as: Lyme Test, Lyme Disease Test, Lyme Titer, Lyme Antibody Test with Reflex
On your lab requisition: Quest “Lyme Disease Ab with Reflex to Blot (IgG, IgM)” (test code 6646)
The short answer
Lyme Disease Serology with Reflex measures Lyme IgG/IgM Antibody Screen, Western Blot IgG (if reactive) and Western Blot IgM (if reactive) from a standard blood draw. At TestWell it costs $64.99 plus a $6 lab processing fee, needs no fasting, and results post in 3–7 business days. Physician-authorized with no doctor's visit or insurance needed; draw at Quest.
Hospital Lab
$200
cash pay
Other Labs
$100
+ lab fees
TestWell
$64.99
+ $6 lab processing fee
Lyme disease testing follows the CDC-recommended two-tier approach. The first tier is an ELISA or immunoassay that screens for Lyme antibodies. If the screen is positive or equivocal, a confirmatory Western blot is performed. This reflex approach reduces false positives while maintaining high sensitivity. Testing is most accurate 4–6 weeks after a suspected tick bite.
Two-tier Lyme serology: ELISA screen followed automatically by a Western blot confirmatory test if positive — the CDC-recommended diagnostic algorithm.
Anyone with known tick exposure, characteristic erythema migrans (bullseye) rash, or unexplained fevers/joint pains/neuropathy living in or recently visited a Lyme-endemic region (Northeast, mid-Atlantic, upper Midwest, parts of CA/OR).
Sample Type
Blood draw
Fasting
Not required
Results In
3–7 business days
Performed At
Quest
3 biomarkers tested
Your Lyme Disease Serology with Reflex results will include values for each of the 3 biomarkers tested, along with reference ranges. Results are reviewed by a licensed physician before being released to your secure portal.
If any values fall outside the normal range, your report will include guidance on what that may mean and recommended next steps. You'll receive an email notification when your results are ready, typically within 3–7 business days.
Typical reference range layout
Lab reports show where your value sits relative to established reference intervals—your physician interprets this in context for you. Already have results? Analyze them with your AI assistant against our physician-reviewed ranges.
No fasting required. Testing is most accurate 4–6 weeks after a suspected tick bite.
The short answer
Worth it when the timing is right. This is the CDC-standard two-tier Lyme test (an antibody screen that automatically reflexes to a confirmatory Western blot), which is the correct way to test - but antibodies take 4-6 weeks to build, so testing too soon after a bite gives a false negative.
We would rather you order the right test than the most expensive one.
This is a venous blood draw at Quest or Labcorp (billed under CPT 94322 for the two-tier reflex), or an at-home mobile draw where available - no fasting required. The reflex design means you pay for one order and, if the initial antibody screen is reactive, the confirmatory Western blot runs automatically on the same sample. TestWell's price is $40.99 versus roughly $65 at Quest Direct.
The markers that matter most and what an out-of-range value can mean. Reference ranges vary by lab, age and sex.
| Marker | Typical range | What it means |
|---|---|---|
| Lyme antibody screen (EIA/ELISA) | Non-reactive = negative | A non-reactive screen 4-6+ weeks after exposure makes Lyme unlikely. A reactive or equivocal screen automatically triggers the confirmatory Western blot - a single reactive screen is not a diagnosis on its own. |
| Western blot IgM (reflex) | Reported if screen reactive | IgM turns positive earlier in infection; it is most meaningful in the first ~4-6 weeks and can be a false positive later, so it is interpreted with timing in mind. |
| Western blot IgG (reflex) | Reported if screen reactive | IgG develops later and is the more reliable confirmation for infections older than 4-6 weeks. A positive screen plus a positive IgG blot supports a Lyme diagnosis in the right clinical picture. |
This section medically reviewed by Youmna DiStefano, MD — updated July 2026. General health information, not medical advice; interpret results with a qualified clinician.
A Lyme Disease Serology with Reflex test costs $64.99 at TestWell — $70.99 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 closest equivalent lists at $100.00 at Quest Health and $99.00 at Labcorp OnDemand (list prices checked Sep 12, 2026; see the notes on how the products differ). Hospital outpatient labs typically bill around $200.00 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. Full cost breakdown →
| Where you order | Price | One test, all-in | Notes |
|---|---|---|---|
| TestWell (drawn at Quest) | $64.99 | $70.99 | Includes the one $6 lab processing fee, charged once per order |
| Quest Health (Quest Diagnostics' own site) | $100.00 | $100.00 | Both include reflex confirmation of positive screens · list price checked Sep 12, 2026 |
| Labcorp OnDemand (Labcorp's own site) | $99.00 | $99.00 | Labcorp OnDemand sells the antibody screen alone; TestWell's reflexes to Western blot confirmation · list price checked Sep 12, 2026 |
| Hospital outpatient lab, self-pay (typical) | $200.00 | $200.00 | Reference figure; hospital charges vary widely by facility and are often higher |
28% less than the lower lab-direct list price, for the same draw at the same lab. Lab test codes: Quest test code 6646. Competitor prices are read from the linked public pages and re-checked regularly; the labs' sites may add taxes or change prices without notice.
Compare more: Quest Diagnostics price list · Labcorp price list · Quest vs Labcorp · Lab test price checker
Antibodies take 2-6 weeks to develop. Testing within the first 2 weeks of a bite often shows false negatives — treat empirically if you have erythema migrans rash without waiting for serology. Retest at 4-6 weeks if early test is negative but symptoms persist.
On TestWell the Lyme Disease Serology with Reflex is $64.99 with no insurance required — vs $100 at Quest, $99 at Labcorp OnDemand (screen only), and $120-$300 at clinics and hospital labs. The reflex Western blot (if your screen is positive) is included in that price, not billed separately.
94322 is Quest's Tick-borne Disease Acute Molecular Panel — a PCR test that looks for tick-borne pathogen DNA (Borrelia, Anaplasma, Babesia, Ehrlichia) in the first ~14 days after a bite, typically $250-$400 cash. It's a different test from this one: our $64.99 two-tier serology is the CDC-recommended standard from 4-6 weeks post-exposure onward, which is when most people test. If you're within 2 weeks of a bite with symptoms, see a clinician promptly rather than waiting on any lab test.
Among antibody (serology) options, the two-tier test with reflex is usually the best value because the confirmatory Western blot is bundled: $64.99 all-in on TestWell, vs $100 at Quest and $99 at Labcorp OnDemand for the screen alone. A standalone ELISA can look cheaper up front, but a positive screen then needs a separately billed Western blot ($80-$150 at most labs) — often costing more in total. PCR panels like Quest's 94322 run $250-$400 and answer a different question (acute infection in the first two weeks). For most people testing 4+ weeks after exposure, bundled two-tier serology is both the recommended test and the cheapest complete answer.
ELISA is the screen — fast, sensitive, but with false positives. Western blot is the confirmatory test — specific but slower. CDC's two-tier algorithm: ELISA first, automatic reflex to Western blot if positive. Our 'with Reflex' option does both in one draw.
It is the CDC two-tier test written as one order line. The lab first runs the antibody screen (an EIA/ELISA for IgG and IgM against Borrelia burgdorferi). If that screen is positive or equivocal, the lab automatically — "reflexively" — runs the confirmatory immunoblot (Western blot) for IgG and IgM on the same blood sample; if the screen is negative, testing stops there and the report shows only the screen. This is exactly what TestWell's Lyme Disease Serology with Reflex ($64.99) is: Quest test code 6646, one draw, and the confirmatory step is included in the price when it is triggered — nothing extra is billed. The CPT codes are 86618 for the screen and 86617 for each confirmatory blot.
Yes — IgG antibodies persist for years after successful treatment. A positive test with current symptoms warrants treatment evaluation; a positive test years after treatment with no symptoms doesn't.
There is no second visit: when the antibody screen is positive or equivocal, the confirmatory Western blot runs automatically on the same sample (that is the "reflex"). Allow the full 3–7 business days quoted for this test — a negative screen reports sooner, a reflexed sample uses the longer end. Testing is most accurate 4–6 weeks after the suspected tick bite, when antibodies have had time to form.
TestWell's two-tier Lyme serology with reflex is $64.99 - the code 94322 refers to the reflex-to-Western-blot design where a reactive screen is automatically confirmed. The same two-tier testing is $100 at Quest, and Labcorp OnDemand charges $99 for the antibody screen alone, with no doctor visit or referral needed and results in 3-7 business days.
A standalone Lyme antibody screen (ELISA alone) can look cheaper, but on its own it is not diagnostic and a reactive result still needs a confirmatory Western blot - so you often end up paying twice. The two-tier reflex test at $64.99 bundles the screen and the automatic confirmation into one order, which is both the CDC-recommended approach and usually the better value.
Wait at least 4-6 weeks. Lyme testing detects your antibodies, not the bacteria directly, and antibodies take weeks to build - so testing in the first few days after a bite is frequently falsely negative. The exception is a classic bull's-eye rash, which is treated on sight without waiting for a test.
A Lyme antibody test costs $64.99 out of pocket at TestWell ($70.99 all-in with the $6 per-order lab processing fee) — it is sold here as the Lyme Disease Serology with Reflex, with no doctor's visit or insurance required. Ordered directly from the labs' own sites, the same test lists at $100.00 at Quest Health and $99.00 at Labcorp OnDemand (checked September 2026). Results in 3–7 business days.
No, fasting is not required for a Lyme Disease Serology with Reflex test — you can eat normally and book any time of day. Testing is most accurate 4–6 weeks after a suspected tick bite.
Order the Lyme Disease Serology with Reflex test online from TestWell for $64.99 (plus a $6 per-order lab processing fee) — no doctor's visit, referral or insurance needed. A licensed physician authorizes the order, then you walk into any Quest patient service center near you for the draw (the lab locator on our site lists the closest ones by ZIP code), and results arrive in 3–7 business days.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
Related guide
Lyme Disease Testing Explained: How Two-Tier Testing Works and When to Test After a Tick Bite
TestWell Price
$64.99
+ $6 lab processing fee at checkout
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Lyme Disease Serology with Reflex
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