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COVID-19 Test Prices Set by Hospitals Range from $20 to $850
Over half of hospitals set COVID-19 test prices between $100 and $199, but some facilities charge as much as $850 for the diagnostic test alone, while others charge as little as $20, an analysis shows.
COVID-19 test prices significantly varied by hospital, with some facilities charging as little as $20 for the diagnostic test, while others charged as much as $850, according to a recent Peterson-KFF Health System Tracker analysis.
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Most health plans must cover COVID-19 testing with no cost-sharing, according to two major pieces of legislation passed at the start of the COVID-19 pandemic in March 2020: the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
Federal laws have also established resources for free COVID-19 testing for uninsured individuals.
However, at date, no federal law exists to regulate the price of COVID-19 diagnostic tests or other related tests and visits outside of Medicare, researchers pointed out. Therefore, hospitals and laboratories are at liberty to set COVID-19 test prices for privately insured and uninsured individuals. Although the CARES Act does require providers to post cash prices for COVID-19 tests on their public websites for insurer use.
Researchers at the Peterson-KFF Health System Tracker examined these COVID-19 test prices when available for the two largest hospitals in each state and the District of Columbia to determine cash prices for COVID-19 diagnostic and antibody tests, as well as how much the prices varied.
Only 78 out of the 102 hospital websites examined yielded pricing information for COVID-19 tests, researchers reported.
Additionally, COVID-19 test prices listed on hospital websites significantly varied by facility, and even within the same hospital system. This variation was due to a hospital’s ability to post different prices for a test for various reasons, including the type of test rendered, where it was performed, and which laboratory analyzed the sample, researchers explained.
Most hospitals, however, set prices above $100.
Researchers found that the median price for a COVID-19 diagnostic test was $127, and about half of test charges (51 percent) were priced between $100 and $199. Nearly one in five (19 percent) were priced above $200, researchers reported.
The COVID-19 test prices are significantly higher than the amounts Medicare reimburses for the same tests. Medicare reimburses providers $51 or $100 per diagnostic test, depending on the type of test conducted.
COVID-19 test prices set by hospitals were generally lower for laboratory tests created by the CDC, while tests using high throughput technology designed for faster analysis of samples were priced higher, researchers stated.
Prices for COVID-19 antibody tests ranged between $36 and $300, with 82 percent of the posted prices below $150, the analysis uncovered. However, only 29 of the 102 hospital websites examined had pricing information for antibody tests.
In addition, the analysis found that not all hospitals offered COVID-19 antibody tests, which are largely used to identify patients with prior infection.
The findings raise concerns about patient billing, researchers said.
“Many privately insured patients who do receive full coverage for COVID-19 testing as intended under the law may still see the impact of testing costs reflected in their premiums for the following year,” they wrote in the analysis. “Other patients might not be protected from receiving bills for COVID-19 testing or testing-related services, however; in addition to the test itself, patients may incur charges for related services, including the visit (in-person or telehealth) during which the patient is evaluated, the collection of test specimen, and other diagnostic tests or procedures ordered to confirm COVID-19 or rule out other possible conditions.”
As evident from the analysis, these charges may be excessive and unexpected for patients, leading to significant financial hardship for some individuals.
But the problem with hospital prices is not new, researchers highlighted. And while policymakers included hospital price transparency policies in COVID-19 legislation, price shopping for COVID-19 testing was not the intent of the laws, they added.
“In this pandemic, the risks of not getting tested can be harmful to both the patient’s health as well as public health. As some patients continue experiencing high and unpredictable costs for COVID-19 testing despite best intentions from Congress to limit those bills, cost could continue to be a barrier for patients in accessing care during this pandemic,” the analysis concluded.
