Because of limited testing availability, a patient traveled 30 minutes to a freestanding emergency room in Texas to get tested for COVID-19. The emergency room bill included a $54,000 charge for one test, according to Kaiser Health News.
Travis Warner traveled to SignatureCare Emergency Center in Lewisville, Texas, after one of his colleagues tested positive for COVID-19 in June 2020. Mr. Warner received two COVID-19 tests, one diagnostic PCR test and a rapid antigen test, according to the report.
The total bill was $56,384, including a $54,000 charge for the PCR test, $600 for an antigen test and a $1,784 for an ER facility fee. Mr. Warner was insured through Molina Healthcare, which ended up paying a negotiated rate of $16,915. The freestanding ER was out of network for Mr. Warner, the report stated.
Mr. Warner's PCR bill of $54,000 is nearly eight times the highest charge previously seen for a COVID-19 test, and Molina Healthcare paid more than double that high charge of $7,000, according to Kaiser Health News.
Medicare pays $100 for the PCR test; at-home rapid tests are sold for $24; and at-home PCR tests are sold for $119.
Though Mr. Warner was not on the hook for the bill, because Congress passed laws that required insurers to pay for COVID-19 testing without copays or cost-sharing for the patient, health experts called the charges "one of the most egregious" they've seen, according to the report.
Health experts say the policy enacted by Congress to limit cost-sharing unintentionally gave providers leeway to charge higher prices, knowing that insurers must pay, and patients are unlikely to complain with a $0 payment.
"People are going to charge what they think they can get away with," said Niall Brennan, president and CEO of the Health Care Cost Institute, a nonprofit that studies healthcare prices, told Kaiser Health News. "Even a perfectly well-intentioned provision like this can be hijacked by certain unscrupulous providers for nefarious purposes."
A spokesperson for Molina Healthcare told Kaiser Health News: "This matter was a provider billing error which Molina identified and corrected."
SignatureCare Emergency Centers told Kaiser Health News it wouldn't comment on a single patient's bill, but that its billing error rate is less than 2 percent.