Better Solutions for Healthcare

Fierce Healthcare: Price gouging gets worse for out-of-network COVID-19 tests

By Robert King

November 16, 2020

New data from an insurance industry group find price gouging for out-of-network COVID-19 tests has increased since a July survey, and insurers want Congress to step in.

The data (PDF), released Monday from America’s Health Insurance Plans (AHIP), comes as most providers agreed to offer COVID-19 testing and treatments without cost-sharing.

AHIP conducted a survey of 22 of its members, representing 76% of commercial enrollment of AHIP member plans.

On average, a COVID-19 test in the commercial market costs $130, and out-of-network tests cost more than $185.

“Between 9% and 16% of out-of-network test claims charged more than $390 (three times the average cost),” AHIP’s report said.

It found that nearly a quarter of COVID-19 tests are administered out of network, which is a 14% increase from a similar survey of 22 members taken in July.

AHIP found that the out-of-network costs were also going up….