self pay for CTX P1NP

You should not have been charged. Go back through Jason. In their contract Quest is not allowed to bill. I'm certain it is just a billing error. You'd better keep the 167. 77.

My Endo prescribed CTX and P1NP at my request. (She told me that these two blood markers have not been proven to be indicative of bone loss.) My insurance didn't pay for either and my out-of-pocket cost for both was approx. $220.00. When I asked insurance why the charges, I was told your doctor can resubmit the test w/different codes. I didn't want to do that and paid the test charges.

If your doctor's office fills out the form for medical necessity of the test, your insurance may pay. Otherwise, Quest makes the profit. Some physicians will tell you that the bone markers are not medically necessary.
privatemd is list price$ 177/$ Ulta 119 for CTX.

I mistakenly thought that you'd gone through Jason and Quest accidentally billed you as well.

Mine cost me nothing for labs and tests. I suggest everyone call their insurance companies BEFORE they get services and find out the guidelines. "Medically necessary" or "medical necessity" are usually the terms needed. Doctors or patients can write the insurance companies for coverage, appeals and reimbursements.

I understand why the tests are not necessary. There is research that says that they are not conclusive. They have to be done properly and at proper intervals. So, you really DON'T need them! It is a nice luxury to have if you can get it covered because it can support/sustain your enthusiasm along the way.

Most of the tests prescribed are not medically necessary, except we don't know until we have them. And we probably don't want our physicians to guess.
One of the endocrinologist I consult with said that he doesn't prescribe without bone markers. He won't risk the moral hazard of prescribing medication to a woman on the verge of fracture without understanding whether the drug is effective.
If your osteoporosis doctor is passive you could be on a useless, expensive, potentially harmful medication for two years between dxas.
Bone markers are never used to diagnose osteoporosis.

My primary dr. prescribed prolia back in 2022 and thankfully I refused. At the time I started walking more and was diligent about calcium and vitamin D intake. Unfortunately 2.5 years later my Dexa scores got worse. I'm now seeing an Edno. It took 6 months to get in. My lab work has been completed and he indicated I should start Forteo, Tymlos or Evenity, the drug choice is up to me. I scheduled a telehealth appointment to ask more questions and hope to make a decision and a plan going forward. Right now I'm leaning towards Tymlos. My labs did not include a CTX or P1NP test and I don't know my Edno's opinion on those tests. It's possible my insurance will not cover them however, I have heard many times how important those test are. Hopefully one of those drugs will get approved along with the necessary labs. lads. (fingers crossed) My question for you is 1. Once I start taking the drug how often is it recommended to get the CTX and P1NP labs? 2. How would I get a 3-6 month supply of Tymlos? I travel out of the country during the cold winter months.
I do have the Great Bones book ordered but I'm afraid it won't arrive prior to my appointment, that is why I'm asking here.
Thanks for your help

Tymlos is a great choice.
bone markers 1 before starting the medication for baseline
2 after two or three months
3 at sixteen month
You will probably always get a three month supply, because of shipping costs to the Speciality Pharmacy for your medication. I've gotten four months by talking to the pharmacy, but I'm on Forteo.
The endocrinologist I see orders bone markers baseline and then every three months. It can be easier on the physician if there is a standing order. I was slow to respond, so he added markers to the standing. Original Medicare covers them, but some insurance policies don't.
Baseline and at three month are worth the cost of finding out whether the medication is working. If your provider won't write for them or the insurance won't pay, the best price is at Jason Health.
One thing about both Tymlos and Forteo is that they almost always work. Some have reported here on Connect that they took these medications for two years without gain.
Some doctors remember from their training that bone markers aren't reliable. In the 1990's standardizaion, new reagents and the importance of an early morning fasting draw have changed that perspective.
I suspect your doctor is smart because he shares my order of medication Forteo or Tymlos and last and least Evenity. I think you are going to have good luck, lurawilson

Thanks @gently! I have read many of your posts! Thank you for your insight! Of course like many others on this site I don't want to start Tymlos, but ever since my July dexa I have been afraid to do many of the activities I love - pickleball, hiking, backpacking, x country skiing and even water skiing. I don't like feeling like a piece of glass ready to break so if I can get the meds approved I will start them! I never knew how serious this diagnosis was but I recently had a wakeup call after witnessed my mother-in-law at age 92 suffer excruciating pain from a compression fracture. She has also suffered from narcosis of the jaw and that is really what originally made me so averse to meds. I understand Tymlos will not cause that however after Tymlos the bisphosphonate my Dr. recommends could. Dr's say it's rare but since I know someone who has suffered from it it made me think it's not that rare. I don't think she reported it anywhere, which probably happens with a lot of side effects from drugs? Anyway, I really do appreciate your input! thanks!

I feel the same about Reclast. Forteo will give you (and the science) two years. And maybe you'll have my luck. I just finished two years of Forteo.
The black box has been removed from Forteo and Tymlos. Now some endocrinologist are extending the use of both drugs.
I pressed the endocrinologist I see for a third year, knowing that I'd need a new prescribing physician if he reiterated the threat of Reclast. He readily agreed to the third year.
But on my last appointment he surprised me promising that he'd keep prescribing Forteo until my Tscore was -1.
Content as I am with what looks like a prescription forever--who ever gets back to a T of -1, if I get that low I will be pressing for yet another year.
And who knows there may be an even better medication for osteoporosis in two year.
Bless our bones.