It is a well known fact that the prices for labs tests can vary widely within one region or state. One study showed that list price for a lipid panel in California varied by a thousand-fold in 2014 (see: Variation in charges for 10 common blood tests in California hospitals: a cross-sectional analysis). Hospital and commercial reference labs can set their test price schedule at whatever level the traffic will bear. However, some employers are combatting this problem through the simple practice of price transparency (see: Using the Reference Pricing Strategy, Safeway and its Employees Reduce Spending on Clinical Laboratory Tests by 32% in Only 24 Months by Selecting Lab with Lowest Prices; Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests). Here is a quote from this first article:
It took just 24 months for Safeway and its employees [in collaboration with Anthem Health Insurance] to pay 32% less for clinical laboratory tests using a new health benefits strategy called “reference pricing.” This strategy targets the large variation in prices that different medical laboratories charge for the same tests and incentivizes employees in a consumer-friendly way to select medical laboratories with lower prices over labs with higher prices....This trend would put those medical labs with the highest lab test prices under significant financial pressure if other employers and health insurers were to incorporate a reference pricing arrangement in their health benefit plans....The study found combined employee and employer savings of $2.57 million over three years. Patients saved $1.05 million in out-of-pocket costs, while their employer, Safeway, saved $1.70 million. Savings were not associated with less testing. Actually, each employee had an average of five to six tests per year over the three years. It was the reference pricing, researchers stated, that led to new choices by employees in where they had lab tests performed.
And here is a quote from this second article about how the lab reference pricing was implemented:
The grocery firm [Safeway] established a maximum payment limit at the 60th percentile of the distribution of prices for each laboratory test in each region. Employees were provided with data on prices at all laboratories through a mobile digital platform. Patients selecting a laboratory that charged more than the payment limit were required to pay the full difference themselves.
For me, one of the most revealing parts of this story was the fact that Safeway and Anthem used a "mobile digital platform" to provide its employees/insurance holders the lab test data prices by lab and the amount of money they would need to be responsible for if a particular lab price was over the 60th percentile ceiling. This is a prime example about how to put essential health insurance price information at the finger-tips of the holders of insurance.