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Price Markups for Clinical Labs: Employer-based Insurance Pays Hospital Outpatient Departments 3x 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, on average, 3 times more for common lab tests such as blood and urine test when billed by hospital outpatient departments compared to independent laboratories. Despite accounting for a third of total ESI use, spending for clinical lab tests rendered at hospital outpatient department accounted for 60% of spending in our ESI sample.
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