South Carolina · K1034

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

South Carolina Medicare Avg
$11.05
5% below national avg
National Medicare Avg
$11.62
All states combined
Billed Charge (SC)
$12.17
What providers submit
Est. Commercial (SC)
$25.96
National avg: $26.03
Est. Cash / Self-Pay (SC)
$11.63
Typical self-pay discount

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

450.4K
Services in SC
635
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in South Carolina

Provider Medicare Services
Wright, Mary Beth APRN $11.76 61.2K

South Carolina Pricing in Context

In South Carolina, 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 $11.05 — 5% below the national benchmark of $11.62. 635 providers across the state submitted claims for this procedure in 2023, performing 450.4K total services. Individual payments in SC 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 South Carolina is $12.17, 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 South Carolina 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 South Carolina lands near $25.96, with self-pay cash prices typically around $11.63. 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 South Carolina?

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 South Carolina is $11.05, which is 5% below the national average of $11.62. Providers in SC typically bill $12.17 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 South Carolina?

With commercial insurance in South Carolina, Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count costs an estimated $25.96. Without insurance, the estimated cash price is $11.63. 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 South Carolina?

635 providers in South Carolina 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 450.4K 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 South Carolina 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 5% below the national average in South Carolina. The state average Medicare payment is $11.05 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