1. What does a longevity panel usually contain?

Four groups, and almost every programme is a selection from them: metabolic, cardiovascular, inflammatory and hormonal. The differences between clinics are mostly about how deep each group goes, not which groups exist.

Group Commonly ordered Why it earns its place in a programme
Baseline CBC, comprehensive metabolic panel, lipid panel The floor. It is cheap, it is what every other result is read against, and an abnormality here changes the rest of the plan.
Metabolic HbA1c, fasting insulin, HOMA-IR (derived) Insulin moves years before glucose does, so a programme that only runs HbA1c finds the same problem later.
Cardiovascular ApoB, Lp(a), sometimes an advanced lipid panel ApoB counts particles rather than cholesterol mass. Lp(a) is largely genetic and is usually run once — repeating it annually is the most common wasted line on a longevity invoice.
Inflammatory hs-CRP, homocysteine Cheap, moves with intervention, and gives a patient something visible to change.
Hormonal Full thyroid panel, total and free testosterone, DHEA-S, IGF-1, oestradiol The overlap with a TRT or HRT programme. If you already run one, most of this is already being drawn.
Micronutrient Vitamin D, ferritin and iron studies, B12, sometimes omega-3 index The group most likely to produce an actionable, inexpensive intervention — and the one most often over-ordered.

Two structural notes worth more than the list itself. Some markers are genetic and belong in a baseline, not a cadence — Lp(a) is the clearest case. And a derived index costs nothing: HOMA-IR is calculated from fasting glucose and insulin, so a programme that draws both already has it and should be showing it.

2. What does the panel actually cost?

Published cash prices for a broad longevity blood panel run roughly $30 to $500 depending on the channel, and the spread is about who is doing the selling rather than what is in the tube.

Channel Published cash range What it means for a programme
Direct-to-consumer panel ~$149 for a packaged longevity panel; broad panels advertised from about $30 to $500 The number your patient will find when they search, so it is the number your programme price is compared against whether you like it or not.
Subscription testing services around $499 a year for a very broad (100+ marker) programme The competitive frame for an annual membership. If your programme costs more, the difference has to be visible in something other than the panel.
Clinic account with a reference or specialty lab Negotiated; commonly well below retail ⚠️ What you may charge on top is set by your state, not by the lab — see the billing rules in the labs guide below.
Add-on Published cash range (2026) Typical cadence
Coronary artery calcium (CAC) score ~$100–$150 typical; $50–$400 across the market Once, then rarely. A score of zero is not re-run every year.
DEXA — body composition ~$40–$200 at a wellness site Quarterly to twice a year while something is being changed.
DEXA — bone density ~$150–$400 without insurance On its own clinical schedule, not the programme\u2019s.
VO2 max ~$150–$350 booked separately Twice a year at most; it is a training measure, not a lab.
Bundled metabolic package (DEXA + RMR + VO2) ~$200 bundled vs ~$75 for DEXA alone ⭐ The bundle is the pricing lesson: bought together, the marginal test is nearly free, which is exactly how a programme should present it.

The arithmetic most programmes get wrong is not the panel. It is the add-ons on an annual cadence: a CAC score and a VO2 max repeated every year turn a $1,200 programme into a $1,700 one for information that did not change.

3. How often should each thing be repeated?

Three cadences, and putting a marker in the wrong one is what makes a programme expensive without making it better.

Cadence What sits here The operator’s reason
Once, ever Lp(a), most genetic markers, a zero CAC score in a low-risk patient It does not change, so a repeat is a line item with no information in it.
Annual The broad panel, hormones in a stable patient, DEXA where body composition is not the focus Matches the membership year, which is also the renewal conversation.
Every 8–12 weeks Whatever is being actively changed — the marker the intervention targets, plus safety labs for anything prescribed This is the only group where frequency buys anything: a patient who cannot see movement stops paying.

⭐ The retention argument for cadence. A programme with one draw a year has one moment of proof a year. The clinics that hold members are the ones where a short, cheap, targeted re-draw lands between the annual panels — not because more testing is better medicine, but because a visible change is what a member is actually buying.

4. How to price the programme around it

Decide first whether testing is inside the price or beside it. Everything else follows from that.

Model How it reads to a patient Where it goes wrong
Testing included in the membership Simple, and the number is comparable to a subscription testing service. Every extra draw is margin out of your own pocket, so the temptation is to under-test the people who need the most.
Membership for care, labs billed at cost Honest, and it survives a price rise at the lab. ⚠️ Several states forbid a practice from standing between the lab and the patient at all. Check before the price list is printed.
Tiered: a baseline panel included, advanced testing as add-ons Most common, and it lets the programme start cheaply. The add-on menu becomes the programme. Cap it, or the upsell is the product.

⛔ Whether you may add anything to a lab charge is a question of state law, not of what the lab says. Roughly nineteen states require the laboratory to bill the patient directly, about eight forbid a markup, and about sixteen require you to disclose the lab and its charge — and those rules bind cash-pay exactly as they bind insured care. That is laid out in which labs will work with a cash-pay clinic.

5. What the software has to do with the results

A longevity programme is a trend, and a trend is only possible if results arrive as values. A PDF filed to a chart is a record of a test; it is not a data point.

Requirement Why the programme fails without it
Analyte, value and unit, stored separately A testosterone of 800 means two different things in ng/dL and nmol/L. Trend lines built on unitless numbers are decorative.
The performing lab’s own reference range, on the result ⛔ Ranges differ by laboratory, method, age and sex. One platform-wide range flags the wrong members and reassures the wrong ones.
Trending from the COLLECTION date Trending on the date a result was filed compresses months of history into whatever week somebody got to the inbox.
A review step before release A member should not read an out-of-range result before a clinician has. This is a workflow requirement, not a feature.
The panel as a reusable order set A programme that re-picks twenty analytes by hand at every visit will eventually order nineteen.

The pairing that makes a programme visible to the member — which numbers to put in front of them and how often — is in outcomes reporting for longevity clinics.

6. Frequently asked questions

How much should a longevity programme charge for testing?
Start from what the patient can find on their own: packaged longevity panels publish at around $149, and broad subscription testing at roughly $499 a year. Your programme does not have to be cheaper, but the difference has to be visible in something other than the blood draw — interpretation, a plan, and somebody who answers when the result is confusing.

Which markers are a waste of money to repeat?
Anything that does not change. Lp(a) is the standard example: it is largely genetic, so it belongs in a baseline and almost never in an annual cadence. A zero calcium score in a low-risk patient is the same argument.

Do we need our own lab account to run a programme?
Not to collect. A site that only draws and ships is not a laboratory under CLIA and needs no certificate; running any test in-office changes that. What an account decides is who bills the patient, and that is constrained by your state.

Is an epigenetic age test worth including?
That is a clinical and commercial judgement rather than a question with an operator answer. What we can say is that the market prices it as a premium add-on rather than a baseline, and that it is usually sold inside a package rather than on its own.

Does this page tell me what to order?
No, deliberately. It describes what cash-pay programmes commonly run and what those tests cost, so the programme can be priced and the software set up. What to order for a patient is their clinician’s decision.