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Nonstandard Size or Width

Tennessee rates for HCPCS L3254

Nonstandard size or width

Rates data updated October 2026.

How much does Nonstandard Size or Width cost?

$10.72

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $10.72 for this service. Most negotiated rates run $7.76 to $14.13.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $11 · 10th to 90th $11 to $11Professionalmedian $11 · 10th to 90th $8 to $14
$10$20$50facility $11professional $11

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$7.08
Median
$7.08
Typical High
$7.08
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$2.82
Median
$2.82
Typical High
$2.82
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$2.09
Median
$2.09
Typical High
$2.14
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
Cigna
Setting
Facility
Modifier
None
Typical Low
$10.72
Median
$10.72
Typical High
$11.22
Cigna
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$7.76
Typical High
$10.72
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86

Where Tennessee sits

The same service costs 27.5 times more in Kansas than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Tennessee· 43rd of 51

$10.72

KS $138SC $5.01

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.