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Lip Biopsy

Georgia rates for HCPCS 40490

This procedure removes a small sample of tissue from the lip to be examined in a lab. It is used to help diagnose a lesion, sore, or other abnormal area on the lip.

Rates data updated October 2026.

How much does Lip Biopsy cost?

$158

Typical negotiated rate. In Georgia, October 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $457 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$102 to $200
FacilityA hospital or hospital-owned outpatient department$457$120 to $1,230

How much rates vary

Facilitymedian $457 · 10th to 90th $83 to $3,388Professionalmedian $148 · 10th to 90th $79 to $263
$100$200$500$1K$2K$5Kfacility $457professional $148

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
$69.18
Median
$5,370.32
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$128.82
Typical High
$331.13
Ambetter
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$223.87
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$380.19
Median
$776.25
Typical High
$3,630.78
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$158.49
Typical High
$257.04
Cigna
Setting
Facility
Modifier
None
Typical Low
$69.18
Median
$93.33
Typical High
$269.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$144.54
Typical High
$275.42
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$141.25
Typical High
$173.78
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$173.78
Typical High
$194.98
United
Setting
Facility
Modifier
None
Typical Low
$79.43
Median
$158.49
Typical High
$1,778.28
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$147.91
Typical High
$323.59
5 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$60.26
Typical High
$70.79
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$13.80
Median
$23.99
Typical High
$28.18
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$51.29
Median
$89.13
Typical High
$104.71
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.23
Median
$17.78
Typical High
$20.89
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.92
Median
$11.75
Typical High
$14.13

Where Georgia sits

The same service costs 3.3 times more in Alaska than in Maryland. 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.

Georgia· 11th of 51

$158

AK $316MD $95.50

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.