Rate benchmarks · Cigna · CPT 99213 · Tennessee

What does Cigna pay for 99213 in Tennessee?

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The median Cigna office rate for CPT 99213 in Tennessee is $75.37 — about 84% of the Medicare allowed amount ($89.36). These benchmarks come from Cigna's federally required price-transparency disclosures, scoped to provider groups practicing in Tennessee and normalized to clean, comparable, per-procedure rates.

Last verified July 2026 · 1,616 contracting groups in Tennessee · national benchmark →

How to read these numbers

A negotiated rate is the contract-specific allowed amount Cigna has agreed to pay an in-network practice for a service — the number that actually lands on your remittance, not the billed charge. Since July 2022, the federal Transparency in Coverage rule has required every commercial insurer to publish every negotiated rate, for every provider group, in public machine-readable files (MRFs). The figures on this page are aggregated directly from Cigna's own filings for CPT 99213, restricted to contracting groups whose clinicians practice in Tennessee.

The median ($75.37 in the office setting) is the middle Tennessee contract: half of Cigna's in-state contracting groups are paid more, half less. The 25th–75th percentile range ($49.09–$93.23) is where the middle half of Tennessee contracts sit — the practical negotiating band for a practice in this market. Below the 25th percentile means most comparable Tennessee groups signed better terms for the identical service, and the dollars between your rate and the median are recoverable on every single visit.

% of Medicare converts each commercial rate to a multiple of the Medicare Physician Fee Schedule allowed amount (CY 2026). Payer contracts are very often written this way — “105% of the current Medicare fee schedule” — because it prices thousands of codes with one number and updates automatically each year. Knowing that Cigna's Tennessee median for 99213 is roughly 84% of Medicare lets you compare offers across codes, payers, and years on one common scale.

Why benchmark 99213 at the state level?

Commercial rates are local. Wage indexes, health-system consolidation, and how much Cigna needs a given network all vary by market, so a national median can over- or under-state what comparable Tennessee practices actually sign. The table above is computed only from groups whose clinicians practice in Tennessee — the peers a Tennessee practice will actually be compared with at the negotiating table. For the widest sample (and codes or settings that are thin at state level), use the national Cigna 99213 benchmark.

Methodology & data freshness

• Source. Cigna's public Transparency in Coverage machine-readable files — the insurer's own federally mandated disclosure of every in-network negotiated rate. No claims data, surveys, or estimates.
• State scope. A contracting group counts as Tennessee when the majority of its clinicians (by NPI registration) practice in Tennessee, so border-town satellite offices don't eject a group and out-of-state systems don't dilute the sample. Benchmarks for 99213 span 1,616 contracting groups in Tennessee, collapsed to one representative professional rate per group.
• Cleaning. Payment-reducing modifier lines (assistant-surgeon, reduced-service, and similar) are excluded, and rates implausibly far from the Medicare benchmark are dropped before percentiles are computed. Settings with too few Tennessee groups for a defensible median are omitted rather than published thin.
• Freshness. Insurers republish these files monthly; benchmarks are rebuilt on the same cadence and this page revalidates daily. Data refreshed July 2026. Medicare comparisons use the CY 2026 Medicare Physician Fee Schedule.

Cigna 99213 in Tennessee — FAQ

Is $75.37 a good Cigna rate for 99213 in Tennessee?

$75.37 is the median — the middle contract — across 1,023 Cigna contracting groups in Tennessee. If your allowed amount for 99213 is below the 25th percentile ($49.09), most comparable Tennessee groups negotiated more than you did, and that gap is usually the strongest line in a renegotiation request. At or above the 75th percentile ($93.23), you are already ahead of most of the Tennessee market on this code. Compare your own rate free →

How does the Tennessee rate for 99213 compare with Cigna's national rate?

Commercial rates vary by market: local wage levels, health-system consolidation, and how competitive Cigna's network is in Tennessee all move the negotiated amount. That is why a Tennessee practice should benchmark against Tennessee contracts — the $49.09–$93.23 middle-half band on this page — before reaching for a national figure. See the national benchmark →

Why does Cigna pay different Tennessee practices different amounts for 99213?

Commercial rates are set contract by contract, not from a single public fee schedule. Two Tennessee practices on the same street can be paid very differently for 99213 depending on group size, specialty mix, negotiating leverage, and how long it has been since anyone re-opened the agreement. That is why the middle half of Cigna's Tennessee contracts alone spans $49.09 to $93.23 — a $44 spread on a single visit.

Can I negotiate my Cigna rate for 99213 in Tennessee?

Usually, yes. Most commercial agreements allow a renegotiation request or renew on an anniversary date, and payers do adjust rates for practices that arrive with data. Showing that your 99213 rate sits below the Tennessee median of $75.37 across 1,023 in-state contracting groups is a far stronger opening than asking for a flat percentage increase. Read the renegotiation guide →

Why are the office and facility rates for 99213 different?

The professional rate depends on site of service. When the visit happens in a practice-owned office, Cigna's Tennessee median is $75.37; when it happens in a hospital outpatient department or ambulatory surgery center — where the facility bills its own separate fee — the professional payment drops to a median of $62.55, because the practice is no longer covering the overhead. Benchmark against the setting where you actually deliver the service.

How current is this Cigna Tennessee rate data?

Cigna republishes its machine-readable rate files monthly under the federal Transparency in Coverage rule, and these benchmarks are rebuilt on the same cadence. This page was last verified July 2026, with Medicare comparisons drawn from the CY 2026 Medicare Physician Fee Schedule.

Source: Cigna Transparency in Coverage machine-readable files, refreshed monthly; last verified July 2026. Aggregate benchmarks over 1,616 contracting groups in Tennessee; no individual practice or contract is identified. EarnestMD is independent and not affiliated with any insurer. This page is informational and is not legal or payer-contracting advice.