Are Some COVID-19 Test Providers Price Gouging?

When U.S. health care providers give COVID-19 tests inside a health insurer’s provider network, the average cost is about $130, according to America’s Health Insurance Plans (AHIP).

When providers give COVID-19 tests to out-of-network patients — without having to comply with the pricing rules in a provider network agreement — the average price is $185, AHIP says.

Providers charged $380 or more for 12% of the out-of-network COVID-19 diagnostic tests given, AHIP says.

Resources

• A copy of the AHIP COVID-19 test price analysis is available here.
• An article about a balance billing hearing is available here.

AHIP has based the COVID-19 test price figures on results from a survey of 22 insurers. It weighted the responses by insurer enrollment.

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

AHIP collected in-network and out-of-network price data for SARS-CoV-2 antibody tests and antigen tests as well as for SARS-CoV-2 diagnostic tests.