As pandemic public health emergency ends, some consumers at risk of high prices for COVID-19 tests

On Thursday the federal public health emergency (PHE) declaration regarding the COVID-19 pandemic ended. New analysis shows this could raise the prices of COVID-19 tests for some consumers.

With the PHE ending, private health plans will no longer be required to cover the full cost of COVID-19 tests that are ordered or administered by a clinician. Neither will these private plans have to reimburse consumers for at-home rapid tests they purchased. 

At-home and over-the-counter tests will no longer be free to insured and Medicare-covered patients. Some insurance plans may still cover these tests. Medicaid recipients will still have the costs of at-home tests covered until September 2024 — after that cost will vary by state.

Most insured people will still have coverage of tests ordered or administered by health professionals, but they may no longer be free. Tests ordered or administered by health professionals could be subject to cost sharing like deductibles, copayments, and coinsurance.

The analysis is available through Peterson-KFF, which monitors and assesses the performance of the U.S. health system. 

Justin Lo is a senior researcher on patient and consumer protections at KFF. Lo made clear that it is not necessarily the case that costs will increase, but that without the PHE guaranteed protections for consumers go away. The prices won’t actually go up – who is paying for it at the end of the day will likely shift.


Lo said the major changes will be with testing and treatment. Lo explained that previously if an individual goes to visit their doctor solely for a COVID-19 test, the entire test would not be out of pocket. This protection is expiring.

What consumers will end up paying for COVID-19 tests will depend on if they are insured, and if so, what insurance they have.

The analysis found that out of every state, the cost of a PCR test at a hospital was most expensive in Alaska, where the median self-pay price is $200. This is compared to the least expensive state, Utah, where the median self-pay price is $41.

Lo said the most commonly ordered test to Alaska is a PCR test rather than an antigen test. This is true in several other states — Lo said when there is no clear recommendation for the best test, clustered geographic variations in what test is ordered occur. PCR tests require more logistics and specific skills and equipment than rapid tests, which leads to different costs.

Analysis of outpatient clinical settings the prices of COVID-19 tests varied significantly. In 2021, the median price of a test in an outpatient clinical setting was $45 for people with large, employer-based health coverage. The median discounted hospital-based self-pay rate was $51 for an antigen test and $91 for a PCR test (among hospitals disclosing price transparency data).

The analysis showed that antigen testing was generally cheaper than PCR testing, with the median price of antigen tests being $42 compared to $62 for PCR testing.

The analysis also found that recent at-home rapid test prices averaged $11 per test, with packs of at-home rapid tests costing between $12 to $24.

Additionally, there may not be additional charges for the health office visit associated with a COVID-19 test. This is dependent on cost sharing arrangements, which for people with private health insurance can average around $90. The report on the analysis said that the combined price of a test in a clinical setting and the related visit could go up to $150 if a deductible applies. This is largely dependent on the clinical setting and health care provider.

Earlier this year President Joe Biden’s administration announced it would terminate the PHE related to COVID-19. Starting in January 2020 under former President Donald Trump’s administration, Congress and the executive branch issued several declarations and pieces of legislation that provided for various protections against the COVID-19 pandemic.

The ending of the PHE will not affect the cost or availability of COVID-19 vaccines, as that is determined by the supply of federally purchased vaccines and not the PHE. Vaccines remain free.

Medicaid unwinding in Alaska started April 1 and will continue over the course of the year. Lo said if an individual is on Medicaid and they survive the unwinding they will still have coverage for testing and treatment. For those that are unenrolled from Medicaid but are still low income, there is a chance they can still get free coverage through the marketplace.

Lo noted that if an individual is disenrolled from Medicaid and becomes uninsured, they could still have access to COVID-19 treatment as the federal government purchased many COVID-19 treatments, which are still free while supplies last.

During the PHE, restrictions on telehealth appointments were lowered, including providers writing prescriptions for controlled substances, but some of these flexibilities will now end. However, some privately insured people will still have telehealth appointments covered, and Medicare beneficiaries will continue to have expanded telehealth opportunities through Dec. 31, 2024.

The analysis from Peterson-KFF was gathered from claims data showing what private insurers have paid for different types of tests; hospitals published self-pay prices for patients without insurance; and from a survey of major retailers’ at-home test prices.