A Sample of Lab Test Cost Savings

A friend posted this image on Facebook with the notation: "thank God for health insurance". 

2018 Prices for Lab Work.jpg

While it's important to have health insurance, it's also important to understand how it inflates and distorts prices for health care. In the above photo, the insurance price for laboratory testing is shown clearly. What's interesting is if these labs were obtained through our clinic, they would have cost a fraction of the amount reported. Here's a test by test comparison:

 

 

 A comparison of lab costs between typical insurance billing and our prices at Plum Health DPC

A comparison of lab costs between typical insurance billing and our prices at Plum Health DPC

What's crazy here is that the person is being billed at a 765% mark-up from the actual cost of the service. This is why health care in America is so much more expensive - hospitals and health care providers dramatically mark up costs and then 'discount' these costs for insurance companies.

This price 'gamesmanship' is bad for health care consumers. It's bad for folks with insurance and even worse for folks who are uninsured. For example, if this person had 80/20 insurance coverage for these labs, they would end up paying $162.20 - the insurance company would 'pay' $658.80 or 80% and the insured person would pay the remaining 20% of costs or $162.20. 

However, if this person were uninsured, they would bear the full brunt of these charges. The uninsured person would pay the entire $811 for labs that actually cost $106. 

Thanks for reading, and have a great day,

- Dr. Paul Thomas with Plum Health DPC