Also known as: Lyme Test, Lyme Disease Test, Lyme Titer, Lyme Antibody Test with Reflex
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 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 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.
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.
| Where you order | Price | One test, all-in | Notes |
|---|---|---|---|
| TestWell (drawn at Quest or Labcorp) | $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.
TestWell Price
$64.99
+ $6 lab processing fee at checkout
No insurance needed · HIPAA compliant
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Lyme Disease Serology with Reflex
$64.99