John Gerard Mcmanus
em · Augusta-Richmond County, GA-SC
Anthem Blue Cross Blue Shield (GA file) is the worst-paying contract we can score for John Gerard Mcmanus — 80.5% of local peers, paid by the same payer for the same codes in the same metro, are paid more. That is the payer's pricing decision, not a reflection on this provider.
Position by payer
Your median contracted rate vs the local peer median, per payer, for every payer we can score in Augusta-Richmond County, GA-SC. Where a Blue Cross entity's label carries a state, that state names the file we found the rate in, not this practice's location — Blue Cross plans file separately per state and do not share rates, even for the same provider.
| Payer | Codes | Your median | Local peer median | Gap | RateScore |
|---|---|---|---|---|---|
| Anthem Blue Cross Blue Shield (GA file) | 4 | $149.69 | $206.75 | −$57.06 | 407 |
| Aetna | 1 | $595.31 | $595.31 | $0.00 | 600 |
Documented reimbursement opportunity
The largest per-encounter gaps to the local P90 target, code by code. Modeled from published rates, not guaranteed — per encounter, not annualized.
| Payer | CPT | Your rate | Local median | Local P90 | Per-encounter gap | Peers |
|---|---|---|---|---|---|---|
| Anthem Blue Cross Blue Shield (GA file) | 99291 | $214.48 | $420.86 | $474.12 | $259.64 | 50 |
| Anthem Blue Cross Blue Shield (GA file) | 99285 | $177.10 | $177.10 | $343.24 | $166.14 | 21 |
| Anthem Blue Cross Blue Shield (GA file) | 99284 | $122.27 | $236.40 | $264.30 | $142.03 | 29 |
| Aetna | 99291 | $595.31 | $595.31 | $645.50 | $50.19 | 33 |
| Anthem Blue Cross Blue Shield (GA file) | 93010 | $8.52 | $13.76 | $17.78 | $9.26 | 25 |
What insurers pay nationally for these codes: 99291 · 99285 · 99284 · 93010
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