COVID-19 Test Prices and Payment Policy
Note: this analysis was updated on April 28, 2021.
This analysis examines what large hospitals nationwide charge for out-of-network COVID-19 tests. It finds a wide range of publicly posted prices; in many cases, the prices exceed what Medicare pays for COVID testing.
New federal guidance released in early 2021 under the Biden Administration clarified that insurers must cover testing without cost sharing for asymptomatic individuals and without requiring medical screenings. However, insurers are not required to cover COVID-19 testing without cost-sharing if it is conducted as part of employee return-to-work programs or public health surveillance purposes. Such limits to federal law coverage requirements mean some patients with health coverage may nonetheless receive bills for COVID-19 diagnostic testing and related services, and those bills often can be widely different from patient to patient.
The analysis examines publicly posted prices at the two largest hospitals in each state and the District of Columbia. Although federal law requires hospitals to make COVID-19 prices publicly available on their websites, prices could only be found for 78 of the 102 hospitals examined. The prices reflect what they would charge for out-of-network services. Data on the negotiated rates for in-network services is not available.
The analysis is part of the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.