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Price Markups for Clinical Labs: Employer‑based Insurance Pays Hospital Outpatient Departments 3X More Than Physician Offices and Independent Labs for Identical Tests


The Health Care Cost Institute (HCCI) in collaboration with West Health conducted an analysis of the high prices that employer-based insurance pays hospital outpatient departments for clinical lab tests. We found that insurers are paying 3 times more for identical tests (such as simple blood and urine tests) when billed by hospital outpatient departments compared to physician offices and independent laboratories. In seven states, the markup for lab tests from hospital outpatient departments was over 6 times the median price for the same tests from physician offices in 2019 (Colorado, Indiana, Nevada, New Mexico, North Carolina, Texas, and West Virginia).

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