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Jones Memorial Hospital / Patients & Families / Visitor Policy / COVID-19 Related Testing Costs

 

COVID-19 Related Testing Costs

See below for details about each test, including costs. Because insurance coverages can change suddenly, we urge all patients to check with their insurer to determine your price for COVID testing. 

COVID Diagnostic Test - $150

Sometimes referred to as a PCR test, this test requires a deep swab to the back of your nose to determine if you have an active coronavirus infection. Read below for more information and guidance on insurance coverage.

  1. If you have symptoms or believe you have been exposed to COVID: Phone or use MyChart to contact your primary care provider to determine if you should get tested, and where you can get the test. Your provider will also instruct you if you should quarantine or isolate. Don’t have a PCP?  Call the New York state COVID-19 Hotline:  1-888-364-3065.
    • Most insurers are currently paying for COVID testing if you have symptoms and it is deemed medically necessary for your care.
  2. If you have an upcoming procedure or surgery: New York state requires all individuals be tested for COVID before having a procedure or surgery. In most cases, you must have the COVID test within two to five days of the date of your surgery or procedure.
    • Your physician or surgeon’s office will provide you with a list of where you can obtain the test, and when to have the test performed.
    • Most insurers are currently paying for COVID testing if it is required for you to have a medically necessary surgery or procedure.

Pricing Breakdown

  • Lab Diagnostic Test - $106
    • CPT Code: U0003 or 87635 - $81
    • CPT Code: U0005 - $25
  • Swab Collection - $44
    • CPT Code: C9803 (At a Hospital Location or Clinic)
    • CPT Code: 99211 (At a Non-Hospital Physician Office)

COVID Antibody Test - $140

This is a simple blood test that detects specific proteins on the surface of the COVID virus, and usually determines if an individual has had a previous COVID infection. You will need your provider to order the test; UR Medicine’s guidelines call for only testing patients who:

  • Are being diagnosed or treated for Multisystem Inflammatory Syndrome of Children (MIS-C)
  • Have fully recovered from COVID-19 and would like to donate convalescent plasma
  • Previously had symptoms of COVID-19 but did not receive a test to learn if they were infected
    • We recommend that you wait at least 30 days past a COVID illness to ensure your body has built up enough antigens for the test to detect.
  • At this time, most insurers are not covering the costs for the COVID antibody test that is performed solely for purposes of pandemic control and/or epidemiologic tracking. Coverage is only available when the test is medically appropriate for the diagnosis and treatment of an individual.

Pricing Breakdown

  • Diagnostic Test - $131
    • CPT Code: 86769
  • Venipuncture/Lab Draw - $9
    • CPT Code: 36415

COVID Diagnostic Test Plus Testing for Influenza A/B and/or Respiratory Syncytial Virus (RSV) - $486

Depending on your symptoms, your physician may order a test that will check not only for COVID, but for flu and/or RSV. Regardless of which "Covid PLUS" test is ordered, the cost is $486, and most insurers are currently paying for this testing because you have symptoms and your physician is indicating it is medically necessary through the test order.  

Like other COVID PCR testing, it requires one deep swab to the back of your nose, which will then be used to test for COVID, flu, and RSV if requested.

Information You Must Provide to be Tested

To comply with New York State requirements and aid in contact tracing efforts, patients must provide additional information before a COVID-19 PCR or antibody test can be administered:

  • Home address
  • Phone number
  • Occupation
  • Employer name
  • Work address
  • Employer phone number
  • Whether you work or volunteer in an elementary, secondary school, or post-secondary school, and the name of such school
  • School patient attends (if applicable)

This data is vital to assist in contact tracing, and prevent outbreaks linked to places of work, especially when employees reside in different counties.