We got the EOB from Humana for our son’s PKU test. The billed amount from the lab was $124. Humana paid $6.78. That’s not a typo. Nearly 95% of the bill was written off. I’m curious what it actually costs to administer the test? There was a lab tech working with our son for about 10 minutes, getting drops of blood from his heel. Surely that’s worth more than $6.78? But then again, the amount that Humana paid is explained on the back of the EOB, which states that services are discounted according to the negotiated rate. So Humana and the lab must have agreed on this price long before our son offered up his heel for a blood test.

If we didn’t have health insurance, would we have had to pay $124 for this test? Is the test actually worth $6.78, or is the lab giving Humana such a big discount that they’re doing the test at a loss? This test is vitally important for newborns, and not something that anyone should skip for financial reasons. But for the 770,000 Colorado residents without health insurance, a PKU test would cost 18 times as much as it costs for people with health insurance. Seems a little counterproductive, especially since the majority of the uninsured population cite cost as the reason they don’t have health insurance.