How to Get an ApoB and Lp(a) Test

ApoB and Lp(a) are two of the most useful blood tests for understanding your risk of heart attack and stroke. Each one takes a single tube of blood. Yet many people who ask for them get stuck. The routine panel came back without them, the ordering steps were unclear, or the results sit in a patient portal waiting for someone to act on them.

This guide covers how to get these tests done, what they cost, and what to do once you have a number. If you want the background on what each test measures, start with our guides on what ApoB is and what Lp(a) is.

Why these tests aren't in a standard lipid panel

A standard lipid panel measures total cholesterol, HDL cholesterol, and triglycerides, and usually calculates LDL cholesterol (LDL-C) from those three. ApoB and Lp(a) are different measurements that the lab runs only when someone orders them. They can come from the same blood draw, but they have to be on the order.

Routine panels often leave them out, and many clinicians are still adopting them. History explains part of that. For years, the main US cholesterol guideline built treatment decisions around LDL cholesterol, and there was no medicine aimed at Lp(a), so measuring it got less push.

Guidance has since caught up. The 2026 ACC/AHA cholesterol guideline, written by the American College of Cardiology and American Heart Association together with nine other groups including the National Lipid Association, now recommends measuring Lp(a) at least once in every adult. It also says measuring ApoB is reasonable for people on cholesterol treatment, particularly those with heart disease, diabetes, kidney and metabolic conditions, or high triglycerides, to help decide whether treatment needs to go further.

European and lipid specialty groups got there earlier. The European Atherosclerosis Society recommended testing Lp(a) at least once in adults in 2022, and the National Lipid Association made the same recommendation in 2024.

Way 1: Ask your clinician (with the right words)

If you have a primary care clinician, this route is often the simplest, and the lab will most likely bill your insurance. Ask for the tests by name so they end up on the lab order.

Before the draw, it can help to call your insurance plan and ask whether these two tests are covered for you. Give them the billing codes: CPT 82172 for ApoB and CPT 83695 for Lp(a). Those are the codes Quest Diagnostics lists for these tests.

Way 2: Order it yourself from a direct-to-consumer lab

In most states you can buy these tests online, without a visit. A clinician working with the lab service reviews and approves the order, you get your blood drawn at a local lab location, and the results come straight to you.

Here is what the two largest US lab companies list for their consumer services. Prices were checked on the companies' own sites and are as of October 2026; both run frequent sales, so the price you see may differ.

A few things to know before you buy:

• Availability varies by state. Some states limit consumer-ordered lab testing. The lab's site will tell you before checkout.
• Panels cost more than single tests. If ApoB and Lp(a) are what you're after, buying those two on their own is usually cheaper than a bundle. Our guide to the advanced lipid panel covers what the extra markers in bigger panels add.
• These services usually stop at the result. They deliver lab results without setting up ongoing treatment, so if your number comes back high, you'll still need a clinician to act on it.

Many people get stuck on that last point, so some go straight to the third option.

Way 3: Go through a lipid practice that tests and treats

A practice focused on cholesterol care will order ApoB and Lp(a) as part of your evaluation, read them alongside the rest of your history, and then prescribe treatment to reach a specific target. Testing and treatment happen in the same place, so a high number leads to a plan.

Preval Health works this way. A board-certified preventive cardiologist writes our protocols, and licensed clinicians through our partner telehealth network deliver the care: they order advanced lipid testing including ApoB and Lp(a) (or review results you already have from your own doctor, Function Health, Superpower, or a direct-to-consumer lab), prescribe when treatment is warranted, and recheck your numbers on a schedule that matches the medication. Preval runs as a cash practice with no insurance claims, $99 a month for care, and medicines at cash prices. Our advanced lipid testing page explains how the labs work, and if you're comparing lab memberships, see our Function Health alternatives.

Does insurance cover ApoB and Lp(a) tests?

Often, if a clinician orders them for a documented medical reason. Coverage varies a lot by plan. The basics:

• Lp(a): Coverage is improving since the 2026 guideline. Aetna, for example, now covers a one-time Lp(a) test for all adults 19 and older (Aetna Clinical Policy Bulletin 0381, checked October 2026). Repeat Lp(a) tests are usually not covered, since the number rarely changes.
• ApoB: Coverage is narrower. Aetna's policy, for example, covers ApoB for adults already on stable cholesterol treatment who have reached their LDL goal and have a high-risk condition such as heart disease, diabetes, kidney and metabolic conditions, or high triglycerides, when the result will guide whether to intensify treatment.
• Medicare: Medicare's lab policies in many regions allow ApoB and Lp(a) when a clinician orders them individually for a documented reason, such as characterizing a lipid problem or guiding treatment. Broad cardiovascular screening panels don't qualify.
• Direct-to-consumer tests are usually paid out of pocket. Both Labcorp OnDemand and Quest Health accept HSA and FSA cards.

If you're unsure, the CPT codes above (82172 and 83695) let your insurer give you a straight answer.

Fasting and preparation

Neither ApoB nor Lp(a) changes much after a meal, so these tests generally don't require fasting. A standard lipid panel often doesn't either. The 2026 guideline calls for a fasting panel mainly when there's a family history of lipid disorders or early heart disease, or when a non-fasting triglyceride level comes back at 400 mg/dL or higher.

Individual labs set their own instructions, and bundled tests often come with a fasting requirement. Labcorp OnDemand asks for a 12 to 14 hour fast for its standalone ApoB test and lists no preparation for Lp(a). Follow whatever your order or lab tells you. Water is fine either way.

How often to test

Test Lp(a) once. Test ApoB as often as your treatment needs, with a baseline and then a recheck after each medicine change.

• Lp(a): once, for most adults. Your genes mostly set your level, and it stays fairly stable for life. The 2026 guideline notes that repeat testing is generally not needed. Keep a copy of the result, because it stays relevant.
• ApoB: to track treatment. ApoB changes with diet, weight, and especially medication. Use it as a baseline and then as a follow-up number after starting or changing a cholesterol medicine, to see whether you've reached your goal.

What the numbers mean

For Lp(a), under 75 nmol/L is lower risk and 125 nmol/L or higher is high risk. For ApoB, the goal is under 90, 70, or 55 mg/dL depending on your overall risk. Here is a short version. The ApoB guide and Lp(a) guide go deeper.

Lp(a) can be reported in nmol/L or mg/dL. The two units don't convert cleanly, so compare your result to the cutoff in the same unit your lab used.

The guideline uses these ApoB goals alongside its LDL goals, and leans on them most when triglycerides are elevated or you have diabetes, since that's when LDL cholesterol can understate your particle count (UIC Drug Information Group summary).

Your own ApoB goal depends on your overall risk, which your clinician works out from your age, blood pressure, diabetes status, family history, and other factors.

If both numbers are high, which matters more? Particle for particle, Lp(a) is worse. A 2024 genetic analysis estimated each Lp(a) particle is about 6 times as likely to cause coronary disease as an LDL particle. But most people have far more LDL particles than Lp(a) particles, so ApoB, which counts all of them, carries most of the risk and stays the main treatment target.

What to do if your result is high

A high result calls for a goal and treatment to reach it. For high Lp(a), that means lowering LDL and ApoB harder. For high ApoB, it means diet changes plus medicine if the gap is large.

If your Lp(a) is high

A high Lp(a) adds to your other risks, and a heart attack still isn't inevitable. The FDA has yet to approve a medicine made specifically to lower Lp(a). The first large outcome trial of one, pelacarsen, did not meet its main goal in results announced in September 2026, and other drugs are still being studied (see emerging Lp(a) therapies).

What helps now:

1. Lower everything else harder. The EAS and NLA statements both recommend earlier, more intensive management of other risk factors when Lp(a) is high, mainly getting LDL cholesterol and ApoB lower than you otherwise would. The 2026 guideline says a high Lp(a) should prompt clinicians to consider more intensive LDL lowering.
2. Know your other numbers. Blood pressure, blood sugar, and smoking status matter more when Lp(a) is high.
3. Tell your family. Lp(a) is inherited. Both the EAS and NLA statements see value in testing close relatives (parents, siblings, children) of people with high Lp(a). If several relatives have high cholesterol or early heart disease, our genetic testing page explains the optional add-on for inherited conditions.

If your ApoB is high

ApoB counts the particles that can lodge in artery walls and build plaque, so a high number is a direct reason to look at treatment. Diet, exercise, and weight loss help, and for many people prescription medicine closes the rest of the gap. Our guide on how to lower ApoB walks through what moves the number and by how much, and prescription cholesterol medications covers the options from statins to PCSK9 inhibitors. If a statin plus ezetimibe hasn't been enough, or statins haven't agreed with you, see who qualifies for a PCSK9 inhibitor prescription.

Summary

ApoB and Lp(a) are inexpensive, one-tube blood tests, and the newest US guideline now backs Lp(a) testing for every adult. You can get them through your own clinician, buy them directly from a lab, or go through a lipid practice that orders them and treats what they show.

If you want both in one place, Preval Health's licensed clinicians order the tests as part of care and then treat to a target, as a cash practice at $99 a month for care, with medicines at cash prices.