What You Need to Know
- AHIP says the average cost of a COVID-19 test in the commercial market is $130.
- The percentage of tests costing more than $390 has fallen to 7%, from 12%.
- The percentage of tests costing less than $185 has also fallen.
U.S. COVID-19 testers are sending health insurers fewer shockingly high bills but more very high bills, according to America’s Health Insurance Plans.
The health insurer group looks at COVID-19 testing price trends in an analysis based on commercial market claims data from 17 AHIP member companies.
In Network v. Out of Network
When health insurers are working with the test providers in their own networks, they can bargain for lower prices.
But when an insured patient gets medically necessary testing from out-of-network providers, the federal Coronavirus, Aid, Relief and Economic Security Act of 2020 requires the insurer to pay the test provider’s full listed cash testing price.
Commercially insured patients tested during the first quarter of this year — from January through March — used out-of-network providers for 27% of those tests, AHIP reports. Earlier in the pandemic, during the second quarter of 2020 , out-of-network providers accounted for just 21% of commercially insured patients’ COVID-19 tests.
AHIP found that the average cost for a COVID-19 test in the commercial market is about $130.