--- title: TSH + Free T4 Test type: test id: tsh-free-t4 url: "https://www.test-well.com/tests/tsh-with-free-t4" price_usd: 27.99 lab_fee_usd: 6 all_in_usd: 33.99 cpt: 84443, 84439 category: Thyroid sample: Blood draw fasting_required: false results_in: "1–3 business days" labs: - Quest - Labcorp - BioReference orderable: true reviewed_at: 2026-09-14 order_url: "https://www.test-well.com/cart?add=tsh-with-free-t4&utm_source=ai_agent&utm_medium=markdown" --- # TSH + Free T4 Test > TSH + Free T4 measures TSH and Free T4 from a standard blood draw. At TestWell it costs $27.99 plus a $6 lab 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. ## Key facts | Fact | Value | | --- | --- | | Price | $27.99 + $6 lab processing fee per order ($33.99 all-in for this test alone) | | CPT code | 84443, 84439 | | Sample | Blood draw | | Fasting | Not required | | Results | 1–3 business days | | Labs | Quest Diagnostics, Labcorp, BioReference (NY & NJ) | | Biomarkers measured | 2 | | 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 TSH + Free T4 test tell you? TSH plus Free T4 together — the standard pair for evaluating thyroid function. 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. **Clinical use:** Combined first-line and confirmatory thyroid test in one draw. TSH screens for dysfunction; Free T4 distinguishes primary hypothyroidism, hyperthyroidism, and central causes. ## Who should order it? Anyone with fatigue, weight changes, hair thinning, mood swings, irregular periods, or a family history of thyroid disease — the standard initial thyroid workup. ## Biomarkers measured - [TSH](https://www.test-well.com/biomarkers/tsh) - [Free T4](https://www.test-well.com/biomarkers/free-t4) ## 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 | $39.99 | $45.99 | Choose at checkout; walk-in patient service centers nationwide (not NY/NJ) | | BioReference (NY & NJ) | $24.99 | $30.99 | 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 TSH + Free T4 test cost? 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 or Labcorp) | $27.99 | $33.99 | Includes the one $6 lab processing fee, charged once per order | | 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. ## How do you prepare? No fasting required. Best drawn in the morning. ## Related conditions - [Hypothyroidism](https://www.test-well.com/conditions/thyroid-problems) (E03.9) - [Hyperthyroidism](https://www.test-well.com/conditions/thyroid-problems) (E05.90) - Hashimoto thyroiditis (E06.3) - Subclinical hypothyroidism (E02) ## Common questions about the TSH + Free T4 test ### Why order TSH and Free T4 together? 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. ### How do I interpret the combination? 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. ### How much does TSH + Free T4 cost without insurance? 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. ### What are the CPT codes for TSH and Free T4? TSH is CPT 84443. Free T4 is CPT 84439. When billed together, both codes appear on the requisition. ### Do I need to fast? 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. ### Should I add Free T3 or thyroid antibodies? Add [Free T3](https://www.test-well.com/tests/free-t3) if you have hyperthyroidism symptoms with normal Free T4 (some patients have T3 toxicosis). Add [thyroid antibodies](https://www.test-well.com/tests/thyroid-antibodies) if you suspect Hashimoto's (most common cause of hypothyroidism) or Graves'. The [Complete Thyroid Panel](https://www.test-well.com/tests/thyroid-complete-panel) bundles all four. ### How often should I retest? 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. ## How to order 1. Add to cart: https://www.test-well.com/cart?add=tsh-with-free-t4&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 1–3 business days with reference ranges and flags. ## Related - [Blood Tests for Thyroid Symptoms](https://www.test-well.com/guides/blood-tests-for-thyroid-symptoms) - [Hashimoto's Thyroid Panel](https://www.test-well.com/tests/hashimotos-thyroid-panel) — 3 tests · $97.99 - [Complete Thyroid Panel](https://www.test-well.com/tests/thyroid-complete-panel) — 4 tests · $109.99 - [Women's Health Panel](https://www.test-well.com/tests/womens-health-panel) — 8 tests · $129.99 - [Free T3 (Triiodothyronine)](https://www.test-well.com/tests/free-t3) — $30.99 - [Free T4 (Thyroxine)](https://www.test-well.com/tests/free-t4-test) — $23.99 - [Reverse T3](https://www.test-well.com/tests/reverse-t3) — $35.99 - [T3 Uptake](https://www.test-well.com/tests/t3-uptake-test) — $22.99 - [T3, Total (Triiodothyronine)](https://www.test-well.com/tests/total-t3-test) — $24.99 - [All Thyroid tests](https://www.test-well.com/tests/category/thyroid) - [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/tsh-with-free-t4 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.