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Included below is important information about the cost of COVID-19 testing and resources to help you make a valuable choice. Our goal is to bring transparency and awareness to the COVID-19 cost variability. With COVID-19 infections again on the rise there is also increased need for testing. While COVID-19 testing is covered by your plan with no cost-sharing, it is still important to keep cost in mind when choosing a testing site. Since your employer is a self-funded, being cost conscious is vital to the success of your plan.
While health plans must provide coverage with no cost sharing for COVID-19 testing and associated expenses, medical providers are free to choose what they charge. The cost for COVID-19 testing varies significantly between medical providers.
We have created color-coded lists by state that includes every provider who has filed a claim for COVID-19 testing with any of our health plans. Green indicates a provider has fair pricing, yellow is average pricing, and red is for high pricing. Click the PDFs below to view providers and pricing.
Testing pricing in Oklahoma, Texas, and surrounding states varies from a fair price of $65 to over $800! Remember, these prices do NOT include other associated costs.
Many medical providers and facilities provide COVID-19 testing, but choosing the appropriate location for your situation is important.
Independent laboratory providers such as Diagnostic Laboratory of Oklahoma (DLO), Quest Diagnostics, and Clinical Pathology Laboratories (CPL) generally provide the lowest cost and most convenient testing options. Emergency rooms and hospitals charge the highest amount for testing. ERs are for treating true emergency and life-threatening situations that require immediate medical attention. It is important to utilize an ER ONLY if you are experiencing a true medical emergency.
While finding an appointment and getting your test results timely are important, make sure to ask the provider how much they charge for testing AND the associated charges. A Kaiser Family Foundation analysis found the cost of a single COVID-19 test can range from $20 to $850. Currently, the Medicare reimbursement rate for a COVID-19 test is $51 to $100 based on the type of test.
It is important to note that the testing costs do NOT include any associated charges, such as office visits, specimen collection, etc. In the case of an emergency room (ER) visit, the charges for the ER physician or ER department can be thousands of dollars.
Below are links to additional testing resources.
Under President Biden’s action plan, over-the-counter At Home Covid-19 At Home tests (also know as over-the-counter tests) are required to be covered by health plans starting January 15th.
Many Pharmacy Benefit Managers (PBMs) are setting up Direct Pay options so that members may obtain their Covid-19 At Home tests directly from the pharmacy at no cost. To find out whether your PBM has this functionality, or what the process is for reimbursement, please call us. Team members are available to assist you at (800) 324-9396 Monday – Friday, 8:00 a.m. to 5:00 p.m. Central Standard Time.