Public Health

How much does Coronavirus COVID-19 testing cost? With or without insurance

Khang T. Vuong24 Nov 2020

Quick digest:

  • There are currently two methods to test for COVID-19: testing for an active infection (standard PCR) or testing for past exposure (antibody test).
  • The cost of Coronavirus testing ranges from no-cost to $352 out-of-pocket average at an urgent care clinic to $2,321 in the emergency room.
  • We found a wide range of scenarios where the same test can be free or costs up to a few hundred dollars within the same city. Knowing what you need, where to get it, and when, are three crucial factors to reduce medical expenses.
  • You should check with your insurance carrier beforehand, if you have no insurance or have a high deductible, Mira is a good option to get a free at-home COVID test.

 

For only $45/month, Mira is a new membership program for you to get affordable co-pays for urgent care visits, lab tests, and prescriptions.

For a limited time, get a free at-home COVID test with your membership.

 

How much does the coronavirus COVID-19 test without insurance?

There are multiple ways you can go about getting a COVID-19 test. The most important thing to know is that where you get it matters. 

 

Telehealth (screening only)

Many employees offer telehealth services to their employees through their health benefits plans. In terms of co-pays, they usually range from $0-$100, but multiple insurance carriers have waived costs for telehealth visits. If an individual has mild symptoms, they can do a video visit with a telehealth provider or call a nurse hotline for no cost. Since most of these individuals will be told to self-isolate, they wouldn't need to come into a doctor's office which excludes any further costs. If the individual does require further testing, they will most likely be directed to a local primary care provider or urgent care center which induces further costs.

 

Mira

Mira is a new option for middle-income individuals who are not qualified for Medicaid and ACA subsidies to get essential healthcare. The program has a $25-$45/mo membership fee. You get access to over 200 urgent care clinics, 1600 labs, and over 60,000 pharmacies nationwide. 

Mira offers all members a free at-home COVID-19 PCR test and a $10 antibody test at any LabCorp location.

 

At Primary Care Providers (including lab costs)

When an individual has mild symptoms and seeks a visit with a primary care provider in New York City, the out-of-pocket costs average is $994. For a primary visit with lab tests, the highest average for COVID testing is in Miami at $2,662 and the lowest average being Seattle at $824.

Metro AreaAverage Cost
Boston, MA$1,222.48
Chicago, IL$1,034.20
Cleveland, OH$1,071.51
Dallas, TX$1,551.00
Houston, TX$1,197.35
Los Angeles, CA$1,372.30
Miami, FL$2,661.77
New York, NY$949.44
Salt Lake City, UT$931.22
San Francisco, CA$2,202.25
Seattle, WA$823.53
Washington, DC$1,338.05

SOURCE: Castlight

 

Urgent Care (including lab costs)

When seeking care in New York City at urgent care, an individual with mild to moderate symptoms may have out-of-pocket costs with an average of about $352.

With more severe symptoms in New York City, their costs average at $1336. Miami and San Francisco have the highest urgent care costs among the included cities at about $2000-$3000. The lowest costing city for urgent care visits and lab tests is Seattle, WA at $808.

Metro Area

CityAverage cost
Boston, MA$1,271.00
Chicago, IL$1,042.97
Cleveland, OH$1,039.36
Dallas, TX$1,695.50
Houston, TX$1,227.54
Los Angeles, CA$1,366.59
Miami, FL$2,956.29
New York, NY$1,066.41
Salt Lake City, UT$924.90
San Francisco, CA$2,167.09
Seattle, WA$808.45
Washington, DC$1,331.13

SOURCE: Castlight

 

Emergency Department (including lab costs)

For an emergency department visit in New York City, a patient can expect to pay from $506 to $4985 (average $2,321) for out-of-pocket costs.

With more severe symptoms, their costs can average at $3305. The out-of-pocket costs for emergency care and lab tests are highest in Miami with an average of nearly $4000. The lowest costing city for emergency care and lab tests is in Boston with an average of $1900.

Metro AreaAverage Cost
Boston, MA$1,884.96
Chicago, IL$1,934.94
Cleveland, OH$1,960.57
Dallas, TX$2,576.67
Houston, TX$2,702.30
Los Angeles, CA$2,690.77
Miami, FL$3,996.79
New York, NY$3,034.94
Salt Lake City, UT$2,296.63
San Francisco, CA$3,904.98
Seattle, WA$1,792.54
Washington, DC$2,359.30

SOURCE: Castlight

 

Lab processing

According to QuestDiagnostics and LabCorp, the two largest laboratory chains in the U.S., the Medicare rate to process an antibody test is around $50 and the rate to process a PCR swab test is around $100-$200. Private insurance companies like Blue Cross Blue Shield, OscarHealth, or Aetna often compensate labs a higher amount that is 2-3X the Medicare rates. 
 

Is COVID-19 testing Free? One very important thing to know

There are usually three steps you need to go through to get a test result, each carries a separate charge to you or your insurance.

  1. Most of the time, you will need an initial screening that could be done virtually via telemedicine.
  2. If determined appropriate, you will be directed to a clinic or drive through where you will be swabbed or get blood drawn.
  3. Your sample will be sent to a lab, where it gets analyzed to determine if you are positive or negative (or processed in-clinic if you get a rapid test).

Because there are two to three steps, there are multiple separate charges. According to major insurance carriers' websites, the screening and clinic visits are free, but the lab cost depends on your insurance policy. We did an independent study to verify this and found a wide range of scenarios where the patient was charged $100 by the lab or up to $2300.

Whether the cost of the test is free or not will depend on two factors: First, is if your insurance covers all three steps of the process, and second, how much of the cost will they cover - 100% or part of it. 

 

Received a surprise bill from that “free” COVID test? You're not alone. 

When COVID-19 began to spread in the United States, we knew there were limited amounts of tests available. However, the cost of getting tested remained a mystery. Earlier this year, Congress and state governments mandated free testing for the public, but that didn't stop people from receiving surprise medical bills.

Andrew Cencini had insurance, but he received a $2000 bill. I was under the assumption that all that would be covered, said Cencini, who makes $54,000 a year. could have chosen not to do all this and put countless others at risk. But I was trying to do the right thing.

While there are different testing options that play into cost, it also strongly depends on your location. In this article, we summarize results from multiple studies based on data from "2.5 billion de-identified medical claims for primary care, urgent care, emergency room, lab tests and x-ray" in Boston, MA, Chicago, IL, Cleveland, OH, Dallas, TX, Houston, TX, Los Angeles, CA, Miami, FL, New York, NY, Salt Lake City, UT, San Francisco, CA. Seattle, WA, and Washington, D.C.

By translating technical concepts and statistical analyses into easy-to-read language, we hope to bring a better understanding of (1) how much COVID-19 testing truly costs, (2) how much you will have to pay if you were to receive a bill, and (3) how to get tested for free or at a fair price.

 

What kind of COVID test should I get?

There are currently two methods to test for COVID-19: testing for an active infection (PCR or swab test) or testing for past exposure (antibodies test). PCR tests detect viral materials present in the bodily fluid while antibody tests detect the level of antibodies produced after an infection occurred.

PCR test (diagnostic test): If you have the signs and symptoms of COVID-19 and meet the CDC testing criteria, you may qualify to get a PCR test. PCR tests are either done through a nasal swab or saliva sample and can be collected at a doctor's office, a drive-through testing center, or through a take-home kit. Depending on your testing site, you may need to make an appointment before getting tested. 

Antibody test: If you previously had COVID-19 or may have been exposed to someone with COVID-19, you may get an antibody test. A blood sample is collected and tested for antibodies, which measure the body's immune response to the virus. Antibody tests can be done at urgent care clinics, laboratory testing centers, some doctor's offices, or hospitals.

Note: testing positive for the COVID-19 antibodies indicates that you were most likely infected with coronavirus in the past and you may have some immunity to the virus. Having the antibodies does not necessarily protect you from reinfection and does not protect you from infecting others. 

Regardless of your results on the antibody test or PCR test, it is imperative to continue to wear a mask in public and practice social distancing. For more on the differences between the antibody and PCR test, read here.

 

Factors that determine how much your Coronavirus COVID-19 test will cost

According to a study done by Castlight, the cost of getting a COVID-19 test and treatment depends on several factors: 

Where you live: the cost of getting a COVID-19 test varies greatly across the country and in different cities. If testing costs at your closest testing center are high, check the cost at other testing sites in your region to determine the most cost-efficient testing site near you. 

How serious are your symptoms: if you have severe symptoms, such as high fever, chest pain, and a cough at your time of testing, your provider may want to run additional tests. Additional blood work and x-rays raise the price of a visit to get tested. 

Where you get tested: it is now possible to get COVID-19 tests at drive-through locations, urgent care, primary care offices, hospitals, and at home with a telemedicine visit. The cost of the test varies depending on the type of site you get your test at. 

 

When would my insurance NOT cover coronavirus testing for free?

Albeit federal and state governments made efforts to push insurers to guarantee no-cost testing. Our independent research found thousands of surprise bills from individuals who got tested. Here are the top 3 reasons why people receive surprise bills after getting tested:

  1. Have symptoms, but was not tested: individuals who have symptoms and suspect that it is COVID-19 related may seek care at a medical clinic. But if an approved Coronavirus test was not ordered, the visit may be billed under a different diagnosis and therefore not covered by your insurance. Read more about COVID symptoms.
  2. The test was not FDA authorized: there are many types of tests for different purposes with different sensitivity levels. According to United Health Group, the nation's largest insurer, "tests must be FDA-authorized to be covered without cost-sharing. FDA-authorized tests include tests approved for patient use through pre-market approval or emergency use pathways".
  3. You got a bill from the lab: if you get tested at urgent care, chances are your sample will be sent to a lab for processing. The lab is a separate entity and will bill your insurance or you separately. Depends on your insurance policy, the doctor visit portion is covered, but not necessarily the lab and vice versa.

 

Here is how much an initial screening and consultation cost if you pay out-of-pocket

  • Telehealth or virtual care: the cost of a telehealth visit with a doctor typically ranges from free to $100 dollars. If you have mild symptoms, the provider may tell you to stay home and take no further action. If you have severe symptoms and decide to take an At-Home test, there are a couple of options for payment. You may either bill your insurance or pay an out of pocket cost.
  • Primary care: the average cost of a primary care visit for a patient with mild symptoms in New York City is $235. The average cost for a patient with more severe symptoms is $1220. Costs vary by the primary care provider and the insurance company.
  • Urgent care: some urgent care facilities, such as CityMD, are advertising free or reduced-cost COVID-19 testing, while others are still requiring full payment. The average out of pocket costs at an urgent care location in New York City is $352 if the patient has moderate symptoms and $1336 if the patient has severe symptoms.
  • Hospitals: the average out of pocket costs for an emergency room visit in New York City is $2321 for a patient with moderate symptoms and $3305 for a patient with severe symptoms. 
     

Where can I get tested for COVID-19 if I don't have insurance?

Mira

Mira is a membership that enables people to get affordable copays for doctor visits, lab tests, and prescriptions with or without insurance. A membership with Mira gives members access to 125 clinics, 1600 labs, and 60,000 pharmacies nationwide. Become a member today and get a free, at-home COVID test sent to you
 

Urgent Care Centers - CityMD 

CityMD is advertising low to no-cost nasal swab COVID-19 testing for New Yorkers who are uninsured. The results of this diagnostic test take between 3 and 5 days. CityMD does not require an appointment and has 123 sites in New York and New Jersey. 
 

Private Hospitals - Mount Sinai 

If you are experiencing COVID-19 symptoms, you can schedule an initial screening via telehealth consultation through Mount Sinai NOW. If appropriate, the physician you speak to may direct you to one of Mount Sinai‚s urgent care facilities. Mount Sinai is partnered with CityMD, Cure Urgent Care, and Urgent Care 181, so the cost of a COVID-19 test may vary based on location. 
 

Public Hospitals - NYC Health + Hospital

If you have Medicaid or part of the NYC Care, you will have access to, testing available at several NYC Health + Hospitals. 
 

Drive-through

Drive-through testing is where you drive up to a testing center in your car and medical staff will test you for the virus from your car.

 

Sources:

https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-antibody-tests/faq-20484429

https://greenpointpost.com/citymd-offering-free-covid-19-testing-to-uninsured-new-yorkers

https://www.citymd.com/all-locations

https://www.castlighthealth.com/wp-content/uploads/2020/03/Costs-of-COVID-19.pdf

https://support.pixel.labcorp.com/hc/en-us/articles/360046002633-What-is-the-price-of-the-COVID-19-test-

https://www.castlighthealth.com/wp-content/uploads/2020/03/Costs-of-COVID-19.pdf

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