May 10, 2021 - Health

Some health providers are charging insurers over $1,000 for COVID tests

A person taking a covid test

Photo: GEORGES GOBET/AFP via Getty Images

More than a year after Congress required insurers to pay the full amount charged by out-of-network providers for COVID tests, the procedure has become extremely lucrative for some hospitals and other providers, KHN reports.

Why it matters: Even if patients don't have to directly pay for overpriced diagnostic tests, it adds onto the overall cost of care — which leads to higher insurance premiums.

State of play: Prices can vary from $20 to $1,419 for a single test, a recent KFF survey of the two largest hospitals in each state found. Federal law requires insurers to reimburse out-of-network providers the cash price of the tests posted on their website.

  • Medicare reimburses providers between $36 and $143 per test.
  • Some free-standing emergency rooms are charging more than $1,000 per test, KHN reports. And some in-network payment rates are high as well.

Between the lines: Hundreds of millions of coronavirus tests have been performed since the pandemic began, and they continue to be conducted routinely.

  • With that kind of volume, the cost of artificially high testing prices can add up quickly.
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