COBRA rates are insanely high, usurious and punitive for being a take-it-or-leave-it policy or choice, in my view. Previous commentary offer several ways to appeal this decision. If you had to put the entire test amount on your credit card and they are billing your credit card account, dispute the charge as soon as possible. The cc issuer will freeze that transaction until it can investigate and neither the lab or the cc issuer can "age" the $650 30-60-90 and they cannot report failure to pay to the credit bureaus. If the cc company cannot negotiate a lower price or cannot win an appeal on your claim, the you will have to pay it but it should not affect your credit rating. You may have to pay accrued finance/interest charges back to the original date you disputed the charge, but more and more the card issuers and medical services providers will negotiate at least a token amount and eat the rest. They are affected by this Depression and just want to have some income.

My situation is almost identical, except that I took the test and received its interpretation and advise from my primary physician. On Friday, I received a bill for $723, which is the balance not paid by Medicare or Blue Shield Anthem. Medicare sent me the claim's processing by them and informed me that I should not pay more than Medicare's co-pay, $45.53 to the provider.

I wish there was some advice out there to help someone in my situation. It would cost the insurance company so much less to pay for these treatments than the past 2 1/2 weeks of hospitalization costs.

"Why should the woman's doctor have to fight for compensation from the insurance company?"

The doctor doesn't have to, but because he can articulate the medical necessity better than the patient, he's in a better position to explain the nature of the treatment.

"You also assume that the woman had $650 laying around."

I don't make that assumption but I don't think $650 is prohibitive either. If I have a life threatening illness, I'm willing to put that $650 on my credit card. My husband will be willing to work some overtime. My children will be willing to contribute something as well.

@Ted,

You brought up another good point. If the woman went to the doctor, even if the service turned out to be not covered, I think the charge would still be reduced to the negotiated rate. The woman would be paying $150 instead of $650.

The part that burns me is if the insurance company covered the procedure the "allowable charge" would be about $150 in my experience. Then the insurance would typically pay 80% of that, or $120, leaving the woman with a $30 bill. But because the insurance company denies coverage the woman owes the doctor $650.

The system is screwed.