Individuals without health insurance should pay between $36 and $180 for a COVID-19 diagnostic test, depending on the test. As a result of the delta version, the United States is currently suffering another wave of COVID-19, and it is critical to learn how to get tested for the virus. This page is intended to assist you in understanding how much you may be needed to pay if you are obliged to pay out-of-pocket and where you may get tested at the lowest possible cost.
Table of Contents
The Price of a COVID-19 Examination
Medicare covers COVID-19 testing in hospitals without requiring patients to bear any costs. Medicare reimburses between $36 to $143 per diagnostic test in the hospital setting, but there are no pricing restrictions in the private market. Even though federal law still compels insurers to cover COVID-19 testing for medical reasons, tests for monitoring are not usually paid for by insurance companies. Insurance companies are not required to cover COVID-19 testing if the following conditions are met:
It is a component of employee return-to-work initiatives.
Each state’s largest hospitals charge the highest prices for COVID-19 diagnostic tests.
THE PROS AND CONS OF TEXAS LAW SHIELD AND 4 IMPORTANT CATEGORIES OF WEAPONS
The COVID-19 diagnostic tests (PCR and antigen) and antibody testing are the two primary COVID-19 tests available. Most COVID-19 diagnostic tests will cost between $100 and $200. If you require additional services such as specimen collection or office visits, you may be required to pay other expenses. These expenses will vary depending on your health insurance status, the test you obtain, the location of your care, and the severity of your symptoms. For this study, we called the top 23 urgent care clinics in the United States to obtain information on the out-of-pocket costs associated with their COVID-19 diagnostic tests.
Our research discovered that the average stated cost of a PCR test is $137, and the average reported cost of a fast antigen test is $189. Diagnostic testing is generally available at the expense of $100-$200 at most urgent care facilities. The chart below illustrates the out-of-pocket costs for PCR and fast tests at several urgent care clinics in California.
The test’s location determines the cost of a COVID-19 test
The CARES Act compels private health insurance companies in the United States to cover the expenses of COVID testing. At the same time, the Families First Coronavirus Response Act provides free testing for people who do not have health insurance. However, we discovered that this isn’t always the case in practice. For COVID testing, many patients have been charged ranging from a few hundred dollars to several thousand dollars.
There are a variety of options available for obtaining a COVID-19 examination. The first crucial thing to understand is that the location of your test is essential. The following table details the out-of-pocket expenses associated with being tested for COVID-19 at various facilities.
The quoted pricing for COVID-19 testing varies significantly from hospital to hospital
Medicare covers testing without the need for patients to contribute to the cost of the test, and clinicians get reimbursed between $36 and $143 per diagnostic test, depending on the type of test and how promptly it is done. However, because there are no pricing rules in the private market, the price that insurers must pay in-network hospitals and providers under current legislation is the rate that the hospitals and providers have established and negotiated for the services. Although insurers must reimburse out-of-network providers for COVID-19 tests at the cash price listed on the provider’s website, they may barter that price down on a claim-by-claim basis under the CARES Act.
The test’s location determines the cost of a COVID-19 test
The CARES Act compels private health insurance companies in the United States to cover the expenses of COVID testing. At the same time, the Families First Coronavirus Response Act provides free testing for people who do not have health insurance. However, we discovered that this isn’t always the case in practice. For COVID testing, many patients have been charged ranging from a few hundred dollars to several thousand dollars.
There are a variety of options available for obtaining a COVID-19 examination. The first crucial thing to understand is that the location of your test is essential. The following table details the out-of-pocket expenses associated with being tested for COVID-19 at various facilities.
Fees for COVID-19 testing are in addition to the regular prices
Additionally to the cost of your test, many urgent care clinics may impose additional administrative costs on top of that. These costs may include the following items:
The expense of seeing a healthcare practitioner.
Fee for the use of the facility (cost for seeking care)
Additional diagnostic testing should be performed (flu test, strep test)
Bloodwork
The COVID test is being sent to a third-party laboratory.
Medications and other forms of therapy
When combined with the cost of your test, these additional expenses can soon add up to a significant sum. The amount you are charged is mainly determined by where you obtain tests and whose labs are utilized by the urgent care facility. For example, LabCorp costs insurers $100 for each test it does.
It is critical to understand what factors may contribute to high COVID-19 testing expenses and the steps you may take to prevent paying these fees. Please refer to our post for information about avoiding surprise fees while requesting COVID-19 testing.
Costs associated with it. Aside from the cost of the diagnostic test itself, hospitals charge for specimen collection and the visit itself, whether in person or via telemedicine. When it came to hospital websites, the entire cost of care for a test and its associated services was not immediately identifiable in most situations. In contrast, 30 institutions prominently displayed the list price for specimen collection (which ranged from $18 to $240) visible. There were three different prices mentioned by one hospital depending on where the samples were collected: a skilled nursing facility, a patient’s home, or an outpatient location.
Individuals who pay for their screening and testing may find that the costs mount up quickly. After applying a 60 percent reduction for qualifying self-pay persons, the price of COVID-19 screening in one hospital’s pricing estimator tool was determined to be $77 before discounts in 2020 and $31 after applying the value. Uninsured or self-pay patients may find that such fees and the cost of a diagnostic test and specimen collection are financially stressful or prohibitive, particularly in the labor market’s current state and high unemployment rates.
Factors Influencing the Cost of COVID-19 Examinations
Several factors include determining the cost of COVID-19 testing and treatment.
Geographical location: The cost of COVID-19 testing varies depending on where you live in the country. If testing expenses at your nearest testing center are prohibitively expensive, compare those charges to those at other testing sites in your region to find the most affordable testing site.
If you are experiencing severe symptoms, such as a high temperature, chest pain, and a persistent cough, your provider may recommend additional diagnostic tests. Such tests increase the cost of a visit to the lab to get tested.