The Cost of COVID-19 Testing: 

To date, the U.S. government has funded a huge COVID-19 relief effort, including covering the cost of medically indicated COVID-19 testing for Americans with and without health insurance under the CARES Act and the Families First Coronavirus Response Act, respectively. In March 2022, however, the House passed a federal spending bill that omitted ongoing funding for the program which pays for uninsured individuals to obtain COVID-19 testing, treatment, and vaccinations. The White House is working to secure additional funding, but if the program ends it will mean the end of free testing and treatments for millions of Americans. 

The burden of COVID-19 testing costs, however, isn’t limited to the uninsured. Individuals with insurance may need to self-pay for COVID-19 testing if it is needed for a non-medical indication, such as travel or a return-work program, neither of which are included in the insurance coverage mandate. 

So exactly what is the cost of a COVID-19 test? 

The answer is that the cost varies hugely, even for the exact same type of test. 

Consumer Reports recently investigated the out-of-pocket cost of COVID-19 tests. One of the issues they found is that testing manufacturers and labs are allowed to set their own prices and insurance providers are required to cover testing costs at the price set by the company. In addition, the number of FDA-approved tests is fairly limited, meaning that demand has consistently outstripped supply during COVID-19 surges. This combination has allowed companies to engage in price gouging, preying on desperate consumers. 

A study by America’s Health Insurance Plans in July 2021 found that “On average, a COVID-19 test in the commercial market costs $130. In contrast, out-of-network test providers charged significantly higher (more than $185) prices for more than half (54%) of COVID-19 tests in March 2021—a 12% increase since the beginning of the pandemic. ”

More recently, in December 2021, Mira (a low-cost health care coverage provider) reported on a survey they conducted of the top twenty-three urgent care facilities in the United States to determine the out-of-pocket cost of COVID-19 diagnostic tests. They found that “the average reported cost of a PCR test is $137, and the average cost of a rapid antigen test is $189. Overall, most urgent care clinics offer diagnostic testing at a price between $100-$200.”

In addition to the above, the availability of at-home tests has increased and may provide a lower-cost option if paying out of pocket. Rapid antigen tests (RATS) typically run ~$10 per test. Three at-home molecular tests are currently FDA approved for emergency use and do not require a prescription. These are more sensitive for detecting early COVID-19 infection but are considerably more expensive, ~$75-100 on average.

Bottom line: When purchasing a COVID-19 test, consider what type of test is best suited to your needs and then do a brief cost comparison before paying top dollar.

What Do I Do if My COVID-19 Test Result Is VERY Delayed?  

Many labs are experiencing long delays –5 days or more– in processing COVID-19 PCR tests.    

If this is the case for you, and you are wondering what to do while awaiting your test, you can utilize serial at-home tests (typically rapid antigen tests), if you have access to them. These tests come back in ~ 15 minutes, but they are less sensitive for testing small amounts of the virus and will be negative very early on in the infection. One approach might be to begin testing with antigen tests on day 3 (day 0 is your exposure), then test daily while awaiting the PCR result. 

If you are asymptomatic, never develop symptoms, and antigen tests remain negative 5 days apart (eg day 3 and day 8), it is unlikely you have COVID-19. 

If you have or develop symptoms of COVID-19, and you are not able to obtain antigen tests OR even if the initial antigen test was negative, assume you likely have COVID-19 and isolate accordingly. 

The table below is a basic outline of recommendations regarding what to do while awaiting your PCR test (for a more detailed explanation, including definitions of quarantine vs isolation: https://myvirtualphysician.com/2022/01/22/ive-been-exposed-to-covid-19-what-now/)

*Continue isolating as long as you are experiencing symptoms of COVID-19 and while awaiting test results. You can end isolation after 5 full days if your symptoms are improving AND you are fever-free for 24 hours (without taking any fever-reducing medications), provided your other symptoms have improved.

* Please contact your medical provider if you test positive for COVID-19 and/or if you are experiencing any severe symptoms of COVID-19.