Rhode Island · K1034

Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count in Rhode Island

Rhode Island Medicare Avg
$10.90
6% below national avg
National Medicare Avg
$11.62
All states combined
Billed Charge (RI)
$11.40
What providers submit
Est. Commercial (RI)
$26.70
National avg: $26.03
Est. Cash / Self-Pay (RI)
$11.31
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

190.4K
Services in RI
115
Providers
N/A
Min Payment
N/A
Max Payment

Rhode Island Pricing in Context

In Rhode Island, CPT code K1034 (Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count) carries an average Medicare payment of $10.90 — 6% below the national benchmark of $11.62. 115 providers across the state submitted claims for this procedure in 2023, performing 190.4K total services. Individual payments in RI ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Rhode Island is $11.40, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Rhode Island sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for DME (Temporary) procedures, the estimated commercial insurance price in Rhode Island lands near $26.70, with self-pay cash prices typically around $11.31. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count cost in Rhode Island?

The average Medicare payment for Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count in Rhode Island is $10.90, which is 6% below the national average of $11.62. Providers in RI typically bill $11.40 for this procedure.

What does Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count cost with insurance in Rhode Island?

With commercial insurance in Rhode Island, Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count costs an estimated $26.70. Without insurance, the estimated cash price is $11.31. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count in Rhode Island?

115 providers in Rhode Island billed Medicare for Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count in 2023, performing 190.4K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count cheaper in Rhode Island than the national average?

Yes — Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count costs 6% below the national average in Rhode Island. The state average Medicare payment is $10.90 compared to $11.62 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial