Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Top Providers in Tennessee
| Provider | Medicare | Services |
|---|---|---|
| Memphis Pathology Laboratory | $36.98 | 224 |
Tennessee Pricing in Context
In Tennessee, CPT code 86359 (T Cells Count, Total) carries an average Medicare payment of $36.90 — 0% above the national benchmark of $36.86. 12 providers across the state submitted claims for this procedure in 2023, performing 282 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 $89.87, 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 above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Laboratory procedures, the estimated commercial insurance price in Tennessee lands near $79.34, with self-pay cash prices typically around $52.39. 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 T Cells Count, Total cost in Tennessee?
The average Medicare payment for T Cells Count, Total in Tennessee is $36.90, which is 0% above the national average of $36.86. Providers in TN typically bill $89.87 for this procedure.
What does T Cells Count, Total cost with insurance in Tennessee?
With commercial insurance in Tennessee, T Cells Count, Total costs an estimated $79.34. Without insurance, the estimated cash price is $52.39. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform T Cells Count, Total in Tennessee?
12 providers in Tennessee billed Medicare for T Cells Count, Total in 2023, performing 282 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is T Cells Count, Total cheaper in Tennessee than the national average?
No — T Cells Count, Total costs 0% above the national average in Tennessee. The state average Medicare payment is $36.90 compared to $36.86 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.