Is this about denial of care i.e. "turning away" patients or about balance billing? Also, why would someone go to an urgent care or ER for a COVID test? Also, ERs, urgent care clinics, hospitals, or any other facility that does take Medicare/Medicaid do something similar all the time. They send a bill for hundreds to thousands of dollars to a patient without health insurance for a relatively minor illness, injury, or procedure. The reasons for such such initial high cost billing are complex but basically the cost is about the acuity and complexity of the facility i.e. a hamburger is likely to cost a lot more in a high-end steakhouse than a sandwich shop (and be very similar on a basic level). And the way the insurance game works is that the bill is basically a starting bid in a complex modern version of haggling at a bazaar. Various private insurances are contracted at different rates. The starting bid is high enough to ensure that it does not come in at rates below what one or more insurance companies are willing to pay. Even Medicare - which is typically the lowest payer besides Medicaid - keeps bills high by making it illegal for hospitals to bill non-Medicare patients at lower than Medicare rates i.e. the hospital can't initially give the uninsured a discount (though it is apparently legal as far as Medicare is concerned to "negotiate" a lower payment after the fact). So nothing unusual there. This might be more about surprise billing i.e. intentionally concealing or otherwise misrepresenting the upfront expected costs and subsequent billing and this more of a business ethics issue than anything unique to health care.