Also known as: TSH with Free T4, Thyroid Panel (TSH + Free T4)
On your lab requisition: BioReference “Thyroid Stimulating Hormone (TSH)” (test code 0153-7)
The short answer
TSH + Free T4 measures TSH and Free T4 from a standard blood draw. At TestWell it costs $27.99 plus a $6 lab processing fee, needs no fasting, and results post in 1–3 business days. Physician-authorized with no doctor's visit or insurance needed; draw at Quest or Labcorp.
Hospital Lab
$150
cash pay
Other Labs
$59
+ lab fees
TestWell
$27.99
+ $6 lab processing fee
This panel combines TSH with Free T4 (thyroxine), giving you a more complete picture of thyroid function than TSH alone. Free T4 measures the active, unbound thyroid hormone available to your body. Together, these two tests can distinguish between primary thyroid disease and pituitary problems.
Combined first-line and confirmatory thyroid test in one draw. TSH screens for dysfunction; Free T4 distinguishes primary hypothyroidism, hyperthyroidism, and central causes.
Anyone with fatigue, weight changes, hair thinning, mood swings, irregular periods, or a family history of thyroid disease — the standard initial thyroid workup.
Sample Type
Blood draw
Fasting
Not required
Results In
1–3 business days
Performed At
Quest or Labcorp
Your TSH + Free T4 results will include values for each of the 2 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 1–3 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. Best drawn in the morning.
What can throw off this result
Physician-reviewed “Before your test” pages — what each factor does, for how long, and what to do about it.
A TSH + Free T4 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. Hospital outpatient labs typically bill around $150.00 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) | $27.99 | $33.99 | Includes the one $6 lab processing fee, charged once per order |
| TestWell (drawn at Labcorp) | $39.99 | $45.99 | Labcorp's own cost for this test is higher; same order, same portal, same physician review |
| TestWell (drawn at BioReference — New York & New Jersey) | $24.99 | $30.99 | New York and New Jersey orders route to BioReference; Quest Health and Labcorp OnDemand don't take self-ordered draws in those states |
| Hospital outpatient lab, self-pay (typical) | $150.00 | $150.00 | Reference figure; hospital charges vary widely by facility and are often higher |
Lab test codes: Quest test code 899 · Labcorp test no. 224576 · BioReference code 0153-7. 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
TSH alone catches most thyroid dysfunction, but Free T4 distinguishes primary (thyroid gland) from central (pituitary) hypothyroidism. Ordering both up front avoids a second blood draw if TSH is abnormal — the single most efficient thyroid workup.
Normal TSH + normal Free T4 = thyroid is fine. High TSH + low Free T4 = overt primary hypothyroidism (start treatment). High TSH + normal Free T4 = subclinical hypothyroidism (often watch and recheck). Low TSH + high Free T4 = hyperthyroidism. Normal TSH + low Free T4 = think pituitary.
On TestWell, the bundle is $27.99. Ordering them separately would be ~$22 + $24 = $46. Quest Direct lists the same bundle at $59, walk-in hospital labs typically bill $100-150 without insurance.
TSH is CPT 84443. Free T4 is CPT 84439. When billed together, both codes appear on the requisition.
No fasting required. Try to draw at the same time of day for serial monitoring, and at least 4 hours after your levothyroxine dose if you're on thyroid replacement.
Add Free T3 if you have hyperthyroidism symptoms with normal Free T4 (some patients have T3 toxicosis). Add thyroid antibodies if you suspect Hashimoto's (most common cause of hypothyroidism) or Graves'. The Complete Thyroid Panel bundles all four.
Annually for healthy adults. Every 6-8 weeks when starting or adjusting levothyroxine until stable, then every 6-12 months. Every 3 months in pregnancy.
TSH + Free T4 test results are typically ready in 1–3 business days after your draw at Quest or Labcorp. TestWell emails you the moment they post, and your results dashboard shows each marker against its reference range with a plain-English explanation.
Biotin supplements, ashwagandha and thyroid-support supplements, levothyroxine timing and time of day can change a TSH + Free T4 test result without anything being wrong. Biotin supplements can falsely lower TSH and can falsely raise Free T4 — stop biotin ≥72 hours before the draw. Ashwagandha and thyroid-support supplements can lower TSH and can raise Free T4 — note the supplement on a thyroid panel; a clinician may repeat TSH after a planned pause. Levothyroxine timing can raise Free T4 — draw before the daily dose, then take it. Time of day can shift TSH — keep the draw time consistent between tests. Each factor is covered on our physician-reviewed "Before your test" pages; when one applies, the fix is usually to remove it and retest.
Order the TSH + Free T4 test online from TestWell for $27.99 (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 or Labcorp 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 1–3 business days.
The TSH + Free T4 test is Quest Diagnostics test code 899, Labcorp test number 224576, BioReference code 0153-7 ("Thyroid Stimulating Hormone (TSH)") (CPT 84443, 84439). TestWell orders it under those codes for $27.99 at Quest, Labcorp or BioReference — no doctor's visit or insurance required, results in 1–3 business days. Codes verified against the labs' catalogs in 2026.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
Related guide
TSH vs T4 vs T3: What Each Thyroid Test Measures, Which One to Start With, and How to Read Them Together
Related guide
How Much Does a Thyroid Test Cost? TSH, Free T4, Full Panel and Antibody Prices, With and Without Insurance
Related guide
Blood Tests for Thyroid Symptoms
TestWell Price
$27.99
+ $6 lab processing fee at checkout
No insurance needed · HIPAA compliant
Better value: the Hashimoto's Thyroid Panel
Save $12.98This test is part of the Hashimoto's Thyroid Panel — 3 tests · 5 biomarkers for $97.99, $12.98 less than à la carte.
$97.99$110.97
3 tests · 5 biomarkers
Frequently ordered together
Customers who ordered TSH + Free T4 also added these for a more complete health picture.
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TSH + Free T4
$27.99