Everyone should be able to get the COVID-19 tests they need, and health insurance providers have worked throughout the pandemic to ensure that people have access to COVID-19 testing. But new data from AHIP show that price gouging on COVID-19 tests by certain providers continues to be a widespread problem, threatening patients’ ability to get the testing they need.
On average, a COVID-19 test in the commercial market costs $130. The new data demonstrates that the share of tests charging 50% to 100% above the average costs has doubled (from 18% to 36%) between early in the pandemic and more recently during the current public health emergency.
"As the nation continues to address the pandemic, affordable testing is key to reducing the spread of COVID-19,” said Jeanette Thornton, AHIP’s Senior Vice President of Product, Employer, and Commercial Policy. “COVID-19 testing price gouging threatens the progress we are making against this deadly virus, and we urge the Administration, Congress and policymakers to take deliberate steps to ensure testing is accessible and affordable for all Americans."
Between May and June of 2021, AHIP conducted a survey of health insurance providers in the commercial market to gather information on prices charged by out-of-network providers for diagnostic, antibody, and antigen tests for COVID-19. This builds upon results from previous AHIP surveys on COVID-19 testing.
Key results from the survey include:
- On average, a COVID-19 test in the commercial market costs $130. In contrast, out-of-network test providers charged significantly higher (more than $185) prices for more than half (54%) of COVID-19 tests in March 2021—a 12% increase since the beginning of the pandemic. The share of most egregious charges (more than $390) decreased from 12% to 7% during the same period.
- More than a quarter (27%) of COVID-19 tests in March 2021 were administered out-of-network—a 6% increase since the beginning of pandemic.
- The share of COVID-19 tests at high-cost locations (hospitals and emergency departments) has declined from 18% in the first quarter to only 5% in the fourth quarter of the pandemic.
AHIP’s latest data includes share of COVID-19 tests performed by out-of-network providers, the percent of high-priced out-of-network tests, and the reported testing sites for out-of-network COVID-19 tests.