America’s Health Insurance Plans, the country’s top payer lobbying group, released a report July 20 that highlights not only an increase in out-of-network costs, but an increase in out-of-network tests.
Now, over a quarter of all COVID-19 tests are done out-of-network — up 6 percent since the pandemic began — leaving over half (54 percent) of those patients overpaying. These gouged tests usually cost over $185 or up to $390 compared to the commercial market average of $130, AHIP said.
The price increases don’t align with where tests are being conducted, as high-cost locations like hospitals are being frequented less as more patients visit doctor’s offices.
AHIP recommends Congress set an out-of-network price benchmark to limit gouging and support the development of more affordable, consumer-friendly testing.
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