Cost analysis for CPT U0004 — 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r
Average Medicare Payment
$73.15
2023 data
Total Payments (2023)
$22.9M
Services (2023)
311.3K
Price Change (2020–2023)
-26.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2020 | $99.07 | $178.7M | 1.8M | — |
| 2021 | $74.27 | $164.3M | 2.2M | -25.0% |
| 2022 | $73.71 | $153.5M | 2.1M | -0.8% |
| 2023 | $73.15 | $22.9M | 311.3K | -0.8% |
The most expensive state pays 1.1x more than the cheapest for this procedure. NY averages $73.50 vs WA at $69.45.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $73.50 | $1.8M | 25.0K | 16 |
| LA | $73.50 | $1.6M | 22.3K | 2 |
| PA | $73.50 | $1.2M | 15.8K | 11 |
| NC | $73.50 | $838.0K | 11.4K | 3 |
| DE | $73.50 | $684.1K | 9.3K | 3 |
| NV | $73.50 | $573.4K | 7.8K | 4 |
| MO | $73.50 | $503.1K | 6.8K | 4 |
| FL | $73.50 | $187.9K | 2.6K | 17 |
| KY | $73.50 | $177.4K | 2.4K | 4 |
| UT | $73.50 | $137.6K | 1.9K | 2 |
| MI | $73.50 | $126.6K | 1.7K | 7 |
| VA | $73.50 | $119.1K | 1.6K | 6 |
| OH | $73.50 | $90.0K | 1.2K | 5 |
| MS | $73.50 | $85.3K | 1.2K | 2 |
| WI | $73.50 | $71.6K | 974 | 2 |
| AZ | $73.50 | $55.3K | 752 | 1 |
| CT | $73.50 | $37.9K | 516 | 2 |
| AR | $73.50 | $27.9K | 379 | 2 |
| TN | $73.50 | $27.0K | 368 | 3 |
| KS | $73.50 | $21.4K | 291 | 1 |
| MA | $73.50 | $19.1K | 260 | 1 |
| IN | $73.50 | $13.6K | 185 | 1 |
| NM | $73.50 | $9.2K | 125 | 1 |
| NJ | $73.50 | $2.3M | 31.6K | 20 |
| IL | $73.50 | $5.8M | 78.3K | 15 |
| AL | $73.49 | $822.2K | 11.2K | 7 |
| SC | $73.49 | $681.9K | 9.3K | 5 |
| GA | $73.48 | $200.1K | 2.7K | 9 |
| TX | $73.47 | $807.5K | 11.0K | 20 |
| CA | $73.47 | $2.8M | 38.1K | 38 |
| MD | $73.47 | $313.4K | 4.3K | 8 |
| OK | $73.40 | $659.6K | 9.0K | 7 |
| OR | $73.04 | $23.6K | 323 | 3 |
| WA | $69.45 | $39.1K | 563 | 24 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Lifescan Labs Of Illinois, Llc | Clinical Laboratory | IL | $2.6M | 34.8K | $73.50 |
| Cormeum Lab Services Llc | Clinical Laboratory | LA | $1.6M | 22.2K | $73.50 |
| Northwell Health Laboratories | Clinical Laboratory | NY | $954.7K | 13.0K | $73.50 |
| Professional Healthcare Inc | Clinical Laboratory | IL | $942.9K | 12.8K | $73.50 |
| Meditech Clinical Services, Inc. | Clinical Laboratory | IL | $809.1K | 11.0K | $73.49 |
| Medarbor Llc | Clinical Laboratory | PA | $770.5K | 10.5K | $73.50 |
| Purity Diagnostic Llc | Clinical Laboratory | NJ | $692.7K | 9.4K | $73.50 |
| Andor Labs | Clinical Laboratory | NC | $636.8K | 8.7K | $73.50 |
| Delaware Diagnostic Labs, Llc | Clinical Laboratory | DE | $585.6K | 8.0K | $73.50 |
| Accu Reference Medical Lab, Llc | Clinical Laboratory | NJ | $563.2K | 7.7K | $73.50 |
| Criterion Chemistries, Llc | Clinical Laboratory | AL | $499.2K | 6.8K | $73.50 |
| Hannan Lab Inc | Clinical Laboratory | IL | $472.2K | 6.4K | $73.50 |
| Star Lab, Inc | Clinical Laboratory | IL | $466.4K | 6.3K | $73.50 |
| Sl Consulting Llc | Clinical Laboratory | NV | $465.8K | 6.3K | $73.50 |
| Assure Laboratory Inc | Clinical Laboratory | SC | $443.4K | 6.0K | $73.50 |
| Acutis Diagnostics Inc | Clinical Laboratory | NY | $424.0K | 5.8K | $73.50 |
| Marquis Labs, Llc | Clinical Laboratory | OK | $421.7K | 5.7K | $73.50 |
| Aim Laboratories Llc | Clinical Laboratory | MO | $416.5K | 5.7K | $73.50 |
| Brio Clinical Inc | Clinical Laboratory | CA | $397.7K | 5.4K | $73.46 |
| Primex Clinical Laboratories Inc. | Clinical Laboratory | CA | $384.7K | 5.2K | $73.46 |
Based on the data, CPT U0004 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 26.2% 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.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.