Hospitals are charging up to $650 for a simple, molecular covid test that costs $50 or less to run, according to Medicare claims analyzed for KHN by Hospital Pricing Specialists (HPS). Charges by large health systems range from $20 to $1,419 per test, a new national survey by KFF shows. And some free-standing emergency rooms are charging more than $1,000 per test. The insurance company passes on its higher costs to consumers in higher premiums. Gargantuan volume " 400 million tests and counting, for one type " combined with loose rules on prices have made the service a bonanza for hospitals and clinics. Lab companies have been booking record profits by charging $100 per test. Even in-network prices negotiated and paid by insurance companies often run much more than that. In some cases, hospitals and clinics have supplemented revenue from covid tests with extra charges that go far beyond those for a simple swab. Warren Goldstein was surprised when Austin Emergency Center, in Texas, charged him and his wife $494 upfront for two covid tests. He was shocked when the center billed insurance $1,978 for his test, which he expected would cost $100. His insurer paid $325 for "emergency services" for him, even though there was no emergency. "It seemed like highway robbery," said Goldstein. A World Health Organization cost assessment of running 5,000 covid tests on Roche and Abbott analyzers ... came to $17 and $21 per test, respectively.