Charara, de Cordova and their children are covered by the Employees Retirement System of Texas, a taxpayer-funded benefit plan that covers about half a million people. They hadn’t received any notices about the charges for their son. So they contacted the SignatureCare billing department and asked for an itemized statement. The test charge was indeed $175. But the total balance, including the physician and facility fees associated with an emergency room visit, came to $2,479.

The facility fee was $1,784 and the physician fee $486.

The couple were dumbfounded. Their son’s vital signs had been checked but there had been no physical examination, they said. The interactions took less than five minutes total, and the child stayed in the car. “You’re getting a drive-thru test, and they’re pretending like they’re giving you emergency services,” de Cordova said.

The SignatureCare charges shocked experts who study health care costs. Charging $2,479 for a drive-thru COVID-19 test is a “nauseating” example of profiteering during a pandemic, said Niall Brennan, president and CEO of the Health Care Cost Institute, a nonprofit organization that studies health care prices. “It’s one of the most egregious examples of giving the fox the keys to the henhouse I’ve ever seen and yet another example of the absurdity of U.S. health care pricing.

“Imagine a vendor in any other walk of life being allowed to bill a third party for whatever amount they wanted,” Brennan said.

Insurance companies in Texas typically pay between $100 and $300 for drive-thru COVID-19 tests, said Jamie Dudensing, CEO of the Texas Association of Health Plans. But the association’s members have seen hundreds of out-of-network COVID-19 test charges come in far higher, some in the thousands of dollars.

“There’s no excuse for that, especially in a public health crisis,” said Chris Callahan, spokesperson for Blue Cross and Blue Shield of Texas, which likewise has seen high charges for COVID-19 tests from out-of-network providers.