Cost of COVID testing varies widely
Today's Managing Health Care Costs Number is $850
Source: JAMA
COVID testing remains a conundrum. We likely need to do 4 million tests a day to suppress the pandemic -and are currently only doing 750,000 a day. We need results to be available quickly, and right now the turnaround is often 7 days or longer. We mostly need to do tests for those who are currently infected (and represent a danger to others), but there is a surplus of antibody tests - so many vendors are advertising these. Antibody tests can't tell who is infectious now. many have a high false positive rate so might overstate who's already been infected. The only use case for antibody testing of individuals is to determine who can donate plasma - and no one should assume a positive Ab test means they are immune.
Here's another problem. Although the CARES Act requires that health insurers cover testing (of either molecular or antibody tests), the prices vary widely, and many people who believe they are fully covered are likely to get a bill.
The Kaiser Family Foundation and the Peterson Institute just published results of a study of hospital list prices for COVID testing. They queried web sites and found published prices for 78 of the top volume two hospitals per state (102 total). The costs ranged from $20 to $850
Here's the distribution:
What does this mean?
This understates the cost of testing- many hospitals also collect specimen collection fees and potential office visit fees.
Insurance companies generally don't pay the "list price," but rather pay an agreed upon price substantially lower. However, those who aren't insured or who have the non-ACA compliant plans promoted by the Trump Administration will be on the hook for these amounts. Patients getting care out of network might also see large bills.
The researchers only looked at the two largest hospitals in each state - so they probably missed the most expensive. Reporters separately have found at least one ambulatory center in Texas billing almost $7000, and one patient had a PCP who sent to an out of plan lab which billed over $28,000 (and collected over $25K) for COVID (and related) tests on a throat swab.
The biggest problem today is that we aren't doing enough testing. There are shortages of swabs, reagents, test kits, and personnel.
But the high and variable cost is a problem too. Many will need to be tested frequently -and the top quartile of charges here is just unacceptable. The pandemic continues to shine a light on the dysfunction of our health care finance system.