The Blood Test Conundrum

I used to get all my blood tests at UCSF hospital while undergoing cancer treatment. As diagnostic tests are free in my health plan, they didn't cost me anything!

Later, when I moved into the burbs and settled into a healthy life with just a primary care physician, I'd get my blood tests downstairs from my primary care physician. And I started to get $20 invoices from that clinic.

What gives? Some sleuthing led to this: a clinic at a doctors office often bills under a doctors name, in my case a doctor I had never heard of or met. Once associated with a doctor, it becomes a doctor's visit, subject to the co-pay of a doctor's visit. Never mind the fact that the blood test cost the insurer a lot less when done at a clinic versus a hospital, the incentive of having a blood test downstairs did not beat driving another mile or two to the closest hospital to get that same blood draw for free out of my pocket.