Health Care Providers are Getting Richer from Covid Testing

Back in July of 2020, the Peterson Center on Healthcare and the Kaiser Family Foundation released a little noticed report on COVID-19 test prices outside of Medicare and paid special attention to the lack of federal price diagnostic and other related tests and visits. 

Peterson-KFF found that despite the CARES Act requirement for prices to be posted, COVID-19 test prices on nearly 24% of the hospital websites examined were missing. For those that did have publicly available price information, COVID-19 diagnostic tests ranged from $20 – $850 per single test, not including the price of a provider visit, facility fee, specimen collection, or any other test that may have been included during testing. These services may be covered by insurance, but it is not guaranteed for all patients. Some patients may be billed for testing-related care from the hospital, a provider, or the insurer. The uncertainty around what patients will be charged for health care services contradicts federal attempts at price transparency. 

Confirmation of an active SARS-CoV-2 infection (the virus that causes COVID-19) is done via tests that use molecular “PCR” amplification and antigen-based lab technology. Data from 78 hospitals with listed prices yielded 134 distinct prices for diagnostic tests. The prices ranged between $20 – $850 per diagnostic test, with a median of $127. About half of test charges (51%) were priced between $100-$199, and nearly one in five (19%) were priced above $200. Websites of 102 different non-governmental adult hospitals for 50 states plus Washington D.C.  were used by Peterson-KFF to collect prices for COVID-19 diagnostic and antibody tests.

The price of diagnostic tests can vary based on the type of test performed, where it is processed, the manufacturer, and Center for Disease Control affiliation. Hospital prices for laboratory tests developed by the CDC were generally lower than for other non-CDC tests, and tests utilizing high throughput technology – allowing for faster analysis of samples – were priced higher.

Related costs 

Aside from the cost of a diagnostic test itself, hospitals are billing for specimen collection and office visits, whether in-person or through telemedicine. In most cases, the total cost of care for a test and its related services is not easily distinguishable on hospital websites. However, 13 hospitals clearly posted the list price for specimen collection, which ranged from $18- $200. 

Price for Antibody Tests

Antibody tests look for antibodies created by the immune system in response to an infection, and for the most part are used to signify a prior infection, rather than diagnosing a current one. Prices for antibody tests ranged between $36 – $300, with 82 percent of posted prices below $150. 

Many privately insured patients who do receive full coverage for COVID-19 testing as intended under the law may see the impact of testing costs reflected in their premiums for the following year. Other patients might not be protected from receiving bills for COVID-19 testing or testing-related services. 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 specimens and other diagnostic tests or procedures ordered to confirm COVID-19 or rule out other possible conditions. These prices can also be high and unpredictable.

These issues with healthcare costs are not new. The cost of medical care has been notoriously hidden in the U.S. Both insured and uninsured patients only find out the full cost after they’ve received bills for their care. Hospitals and insurers have historically kept their negotiated rates secret, allowing the same provider to charge different rates for the same service.