Comment by Aurornis | Hacker News Reader

Comment by Aurornis | Hacker News Reader

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FYI the above poster is the founder of the company selling these tests (EDIT: He edited his comment to include the "OP here" intro after I posted my comment. Thanks!)

> In the past, when we've gone through insurance, the insurer's "negotiated rate" for the same exact panel comes out to $1,400-$1,500.

hs-CRP is not going to be a $1500 negotiated rate under any insurance these days. No sane insurance company is going to pay that.

I understand that the negotiated rate you're talking about is for an entire panel of many markers, but most of these are not necessary for a quick screen and many would already be covered by an ACA annual checkup.

> It includes hs-CRP ($59 by itself online),

hs-CRP is $50 right now at privatemdlabs.com before the 25% off coupon they're blasting me with in the pop-up. It appears to be in the $40-45 range at a few other direct lab companies.

I updated the above post to say (OP here). I thought it was fairly clear from my phrasing of "we offer the tests as cash pay", but never hurts to be even more explicit.

I checked privatemdlabs.com, and they're asking $249 for a cardiovascular panel that covers the same biomarkers. So I think our pricing compares pretty favorably, especially when you consider that we offer an MD review.

> hs-CRP is not going to be a $1500 negotiated rate under any insurance these days.

The $1500 insurance price is for the $190 panel. We've actually dealt with this exact situation in the last month, since every so often labs will make a mistake when they process the order (we obviously fix these situations). Perhaps the insurance companies aren't sane (a topic for another day), but this is unfortunately how the system works today.

Commenting to add - Insurance negotiated rate may actually be 1500$. If it is and they charge insurance 1500$. They legally cannot charge an individual a different or lower rate. Even if that person doesn’t have insurance and offers to pay cash.

This is one of those weird horrible traps health insurance puts you into. OP may charge insurance 1500$, insurance may only pay 20%. But that now means they have to charge individuals the full 1500$ price.

So honestly, Cudos to the OP for identifying this trap and then moving to just charging a reasonable flat rate.

Why would the insurance pay only 20% if it's a negotiated rate?

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