2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Lab, X-ray and Other Diagnostic Tests

 

Benefit Description

Lab, X-ray and Other Diagnostic Tests

Diagnostic tests, such as:
 
  • Laboratory tests (such as blood tests and urinalysis)
     
  • Pathology services
     
  • EKGs
     
  • Cardiovascular monitoring
     
  • EEGs
     
  • Neurological testing
     
  • Ultrasounds
     
  • X-rays (including set-up of portable X-ray equipment)
     
  • Bone density tests
     
  • CT scans*/MRIs*/PET scans*
     
  • Angiographies
     
  • Genetic testing*
     
  • Nuclear medicine
     
  • Sleep studies

Note: See Section 5(c) for services billed for by a facility, such as the outpatient department of a hospital.

*Prior approval is required

You Pay
Preferred: 30% of the Plan allowance (deductible applies)

Note: $0 member cost-share for the first 10 laboratory tests performed in each of these different laboratory test categories (Basic metabolic panels; Cholesterol screenings; Complete blood counts, Fasting lipoprotein profiles; General health panels; Urinalysis) and 10 Venipunctures when not associated with preventive maternity or accidental injury care.

Non-preferred (Participating/Non-participating): You pay all charges

Note: When care is provided by a Non-preferred laboratory and/or radiologist, as stated in Section 3 for an exception, you pay:
 
  • Participating laboratories or radiologists: 30% of the Plan allowance (deductible applies)
     
  • Non-participating laboratories or radiologists: 30% of the Plan allowance, plus any difference between our allowance and the billed amount (deductible applies)