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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 0240U
  4. Cost Analysis

How Much Does Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected Cost on Medicare?

Cost analysis for CPT 0240U — Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected

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Average Medicare Payment

$139.01

2023 data

Total Payments (2023)

$27.7M

Services (2023)

198.0K

Price Change (2020–2023)

-2.5%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2020$142.63$27.5K193—
2021$142.12$644.1K4.5K-0.4%
2022$139.34$1.9M13.7K-2.0%
2023$139.01$27.7M198.0K-0.2%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.0x more than the cheapest for this procedure. IL averages $139.78 vs WI at $137.16.

StateAvg PaymentTotal PaymentsServicesProviders
IL$139.78$20.9M149.7K7
KS$139.78$81.8K58510
MN$139.78$34.9K25015
AZ$139.78$31.6K2264
NJ$139.78$27.8K1992
MI$139.78$22.5K1616
FL$139.78$3.7M26.2K14
CA$139.76$2.0M14.5K5
SD$139.57$77.9K55815
NC$139.35$45.4K32612
VA$139.33$37.8K2715
ND$139.24$43.0K3097
AR$139.11$69.8K50217
IA$138.52$90.9K65611
WA$138.44$14.4K1046
TN$138.40$50.4K3647
OK$138.06$76.9K55716
PA$138.05$22.4K1623
OH$137.71$18.6K1356
WI$137.16$273.6K2.0K6

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Sinai Laboratory CorpClinical LaboratoryIL$12.7M91.1K$139.78
Fz Medical Group IncClinical LaboratoryIL$8.0M57.2K$139.78
Gp DiagnosticsClinical LaboratoryFL$3.6M25.9K$139.78
Pacific Medical LabsClinical LaboratoryCA$2.0M14.4K$139.78
Jeffrey BahrInternal MedicineWI$191.2K1.4K$136.06
Goat Mass Swabs IncClinical LaboratoryIL$125.2K896$139.78
Cotton O'neil Clinic Revocable TrustClinical LaboratoryKS$62.5K447$139.78
A2cl Services, LlcClinical LaboratoryWI$58.4K418$139.78
Medical Laboratories Of Eastern Iowa LcClinical LaboratoryIA$45.1K327$138.01
United Eg LlcClinical LaboratoryIL$35.9K257$139.78
Mark RodackerPathologyND$29.9K215$139.00
George GuarigliaFamily PracticeNJ$21.2K152$139.78
Francis MohanFamily PracticePA$19.3K140$137.78
Ylab180 IncClinical LaboratoryIL$17.9K128$139.78
Optima Medical Center IncClinical LaboratoryIL$17.2K123$139.78
Dustin AllenPhysician AssistantVA$16.7K120$138.75
James GastFamily PracticeWI$14.4K103$139.78
Avera MckennanClinical LaboratorySD$13.6K97$139.78
Ernest BuchananFamily PracticeTN$13.3K97$137.14
Hamad AhmadFamily PracticeTN$12.0K87$138.17

🤔 Is Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected Overpriced?

Based on the data, CPT 0240U shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.

Costs have decreased 2.5% since 2020. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.