A covered checkup costs families $0; lab tests are priced from $21 to $1,310

What this chart asks

What would each route the measure allows for verifying sex cost?

Why it is shown this way

• Bars on one linear dollar axis that starts at zero show the gap between a $0 checkup and a $1,310 chromosome test at true scale.
• Color groups the bars by route; each label also names the route, so the chart does not depend on color.
• Each label says what kind of price it is (what a family pays, what a payer pays, a billed list charge, a consumer cash price, or a press-reported figure), because these are not interchangeable.

Data and accessibility

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Dataset sex-verification-test-costs, analysis route-price-comparison

Sources

This chart draws on the sources of the dataset versions it visualizes.

What sex verification under I-638 would cost, by route

1. Washington Health Care Authority, Physician-Related Services fee schedule, effective October 1, 2026 Apple Health maximum allowable fees for CPT 84403, 88230, 88262, 88271, 88275 and 88291.

   Retrieved October 23, 2026. Washington state public record; CPT codes and descriptions are copyright American Medical Association. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Government. HCA runs Apple Health, Washington's Medicaid program, and publishes these fee schedules for billing. Fees are what the state pays providers.

2. Washington Health Care Authority, EPSDT Well-Child fee schedule, effective July 1, 2026 Apple Health payment for a well-child checkup, CPT 99394 (established patient, age 12-17).

   Retrieved October 23, 2026. Washington state public record; CPT codes and descriptions are copyright American Medical Association. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Government. Official Apple Health fee schedule for EPSDT well-child checkups.

3. Washington Health Care Authority, EPSDT Well-Child Program billing guide, July 1, 2026 How often Apple Health expects well-child checkups (one per calendar year for ages 5 through 20).

   Retrieved October 23, 2026. Washington state public record. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Government. Official billing guide for Apple Health well-child checkups.

4. Washington State Department of Health, Child and adolescent well-care visits States that children 0-20 can get a free well visit each year and that most plans, including Apple Health, cover it at no cost.

   Retrieved October 23, 2026. Washington state public record. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Government. Consumer guidance from Washington's health department. It promotes well-child visits.

5. Centers for Medicare & Medicaid Services, Medicare Physician & Other Practitioners - by Geography and Service, 2024 data Medicare average allowed amounts and average submitted charges in 2024 for CPT 84403, 88230, 88262, 88271, 88275 and 88291, national and Washington.

   Retrieved October 23, 2026. U.S. government work, public domain. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Government. Built by CMS from Medicare Part B fee-for-service claims. Covers Medicare beneficiaries only, mostly 65 and older; prices for children are not reported.

6. Quest Diagnostics, questhealth.com: Testosterone Test Consumer price ($69 plus a $6 physician service fee) and age eligibility (patients 18 to 100).

   Retrieved October 23, 2026. Copyright Quest Diagnostics; price quoted for commentary. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Industry. Quest sells this test directly to consumers. Prices change and promotions apply.

7. Labcorp OnDemand: Total Testosterone Test Consumer list price ($69, on sale for $51.75 on 2026-10-23) and age eligibility (18-100).

   Retrieved October 23, 2026. Copyright Laboratory Corporation of America; price quoted for commentary. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Industry. Labcorp sells this test directly to consumers. The page says the test is clinically appropriate only for people assigned male at birth.

8. Quest Diagnostics, questhealth.com: Shop all tests Checked for any chromosome, karyotype or SRY test sold to consumers; none was listed.

   Retrieved October 23, 2026. Copyright Quest Diagnostics. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Industry. Quest's consumer catalog as shown on 2026-10-23.

9. Labcorp OnDemand: All lab tests Checked for any chromosome, karyotype or SRY test sold to consumers; none was listed.

   Retrieved October 23, 2026. Copyright Laboratory Corporation of America. Figures quoted with attribution; the source document is linked, not hosted.

   Reliability: Industry. Labcorp's consumer catalog as shown on 2026-10-23.

10. CVS MinuteClinic price list Cash price of a sports physical ($82), for which MinuteClinic does not accept insurance.

    Retrieved October 23, 2026. Copyright CVS Health; price quoted for commentary. Figures quoted with attribution; the source document is linked, not hosted.

    Reliability: Industry. National retail-clinic price list as shown on 2026-10-23; prices may differ by state.

11. HealthCare.gov, Preventive care benefits for children Well-child visits are covered preventive care, generally at no cost in network.

    Retrieved October 23, 2026. U.S. government work, public domain. Figures quoted with attribution; the source document is linked, not hosted.

    Reliability: Government. The federal Marketplace's consumer page on the Affordable Care Act preventive-care rule.

12. The Spokesman-Review, "Washington voters to decide whether transgender athletes can continue to compete in K-12 girls sports in I-638" (September 27, 2026) The press-reported prices of a testosterone test ($162) and chromosome testing ($1,310).

    Retrieved October 23, 2026. Copyright The Spokesman-Review; figures quoted for commentary. Figures quoted with attribution; the source document is linked, not hosted.

    Reliability: News report. A news story by Mitchell Roland. The prices appear in the reporter's voice, next to quotes from a family physician who opposes the measure; no source for them is named.

13. U.S. Census Bureau, American Community Survey 2024 1-year, Data Profile DP03, Washington Washington residents under 19 with no health insurance (3.9%, margin of error 0.4 points).

    Retrieved October 23, 2026. U.S. government work, public domain. Figures quoted with attribution; the source document is linked, not hosted.

    Reliability: Government. A sample survey; the margin of error is a 90% interval. Retrieved through the Census Data API (variables DP03_0100E, DP03_0101E, DP03_0101PE, DP03_0101PM).

Limitations

• Payer rates and billed charges are not prices a family pays; they bracket what an uninsured family might be charged.
• Medicare figures are 2024 national averages for Medicare patients, not 2026 rates or children's prices.
• The consumer testosterone price is for adults only; Quest and Labcorp do not sell these tests for patients under 18.
• The press-reported prices ($162 and $1,310) could not be traced to a public Labcorp page.
• The two $0 bars have no height: they show what insured and Apple Health families pay for a covered well-child checkup.
• Bars are ordered alphabetically by label, not by price.