A Closer Look at COVID-19 Diagnostic, Antibody Testing Charges

The rates that providers and laboratories charge for COVID-19 diagnostic and antibody testing — prices that “have important implications for out-of-network plans, uninsured patients, and other payers with little negotiating power” because of provisions in the CARES Act — far exceeded their Medicare reimbursement rates, according to a recent study published in the Society of General Internal Medicine. By analyzing administrative claims data from the COVID-19 Research Database, the study found that independent labs — which performed almost half of all COVID-19 diagnostic tests — charged $140.41 on average, while the Medicare rate was $51.31. Independent labs performed more than 95% of all antibody tests, with an average charge of $62.30, compared to the Medicare rate of $42.13. Across the country, average diagnostic testing fees ranged by state, from a low of $64.98 in Utah to a high of $505.65 in Washington, D.C. For antibody testing, New Mexico providers and labs charged an average of $195.41, more than four times of the average charge in New York ($45.85).

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© 2021 MMIT

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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