Tennessee · 31652

Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes in Tennessee

Tennessee Medicare Avg
$134.78
12% below national avg
National Medicare Avg
$153.69
All states combined
Billed Charge (TN)
$1,150.35
What providers submit
Est. Commercial (TN)
$364.97
National avg: $435.86
Est. Cash / Self-Pay (TN)
$443.66
Typical self-pay discount

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

799
Services in TN
113
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Tennessee

Provider Medicare Services
Gilroy, Robert M.D. $163.77 26
Byrd, Shannon MD $104.04 24

Tennessee Pricing in Context

In Tennessee, CPT code 31652 (Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes) carries an average Medicare payment of $134.78 — 12% below the national benchmark of $153.69. 113 providers across the state submitted claims for this procedure in 2023, performing 799 total services. Individual payments in TN 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 Tennessee is $1,150.35, 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 Tennessee 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 Respiratory Surgery procedures, the estimated commercial insurance price in Tennessee lands near $364.97, with self-pay cash prices typically around $443.66. 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 Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes cost in Tennessee?

The average Medicare payment for Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes in Tennessee is $134.78, which is 12% below the national average of $153.69. Providers in TN typically bill $1,150.35 for this procedure.

What does Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes cost with insurance in Tennessee?

With commercial insurance in Tennessee, Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes costs an estimated $364.97. Without insurance, the estimated cash price is $443.66. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes in Tennessee?

113 providers in Tennessee billed Medicare for Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes in 2023, performing 799 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes cheaper in Tennessee than the national average?

Yes — Exam Of Lung Airways And Sampling Of Lymph Nodes Using An Endoscope And Ultrasound Guidance, 1-2 Lymph Nodes costs 12% below the national average in Tennessee. The state average Medicare payment is $134.78 compared to $153.69 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