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Out-of-network providers price gouging COVID-19 tests, AHIP says

August 29, 2020

Out-of-network providers are inflating the price of COVID-19 diagnostic and antibody tests, according to a report from America’s Health Insurance Plans.

AHIP conducted a survey of its member plans in the commercial market and received 22 responses, which represented 67 percent of commercial enrollment of member plans. Responses were weighted based on plans’ enrollment.

Under the Coronavirus Aid, Relief and Economic Security Act, health insurers have to pay the listed cash price for COVID-19 tests to out-of-network providers. AHIP said this has resulted in price gouging, as payers and providers can’t negotiate test prices.

COVID-19 tests usually cost $130. AHIP says out-of-network providers charge more than $185 for 39 percent of diagnostic tests and 25 percent of antibody tests, with 1 in 10 out-of-network providers charging more than $390.

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