As far as the PSE test goes if your health plan says they won't approve it you can't get one . Even if you pay cash out of pocket - without your health care provider signing off on it you can't get one ( unless you go out of country and pay cash ) I'm going through the same situation . Most people don't have access to " centers of excellence " which will approve of many new treatment options - unfortunately most large health care providers don't approve of many of the latest tests , including PSE and genomic testing they will tell you they're not approved by the FDA and that their professional organizations guidelines say these newer tests are dubious and have no credible track record .