Pink Lotus lets you order signatera directly through their website ($200 admin fee out of pocket). Its the same breast cancer clinic that Angelina Jolie went to - Dr Funk. She strongly believes that all women with breast cancer should have access to the test so she made it available, which is fantastic. And you're right - its not standard of care and the docs don't know what to do with early stage patients if Signatera comes back positive, which frankly I think is a poor reason not to offer it to patients because at least you can be aware and try to look at what your options are / start preparing.