This provider's $24.5M in total Medicare payments ranks in the 96th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 5.27x is significantly above the specialty median of 3.7x.
AI-generated analysis based on Medicare payment data.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $55.36 | $12.69 | 4.36x | $42.67 | $2.3M | 210.5K | 137.3K |
| 2015 | $57.32 | $12.69 | 4.52x | $44.63 | $2.5M | 224.8K | 146.9K |
| 2016 | $58.67 | $12.89 | 4.55x | $45.78 | $2.6M | 233.3K | 155.3K |
| 2017 | $60.17 | $13.41 | 4.49x | $46.76 | $2.9M | 242.4K | 161.1K |
| 2018 | $60.71 | $13.14 | 4.62x | $47.57 | $2.9M | 245.3K | 163.6K |
| 2019 | $63.86 | $12.77 | 5.00x | $51.09 | $2.6M | 241.5K | 160.0K |
| 2020 | $75.48 | $16.13 | 4.68x | $59.35 | $2.3M | 205.9K | 139.6K |
| 2021 | $65.89 | $12.37 | 5.33x | $53.52 | $2.1M | 200.3K | 136.2K |
| 2022 | $67.08 | $12.79 | 5.24x | $54.29 | $2.0M | 194.7K | 130.0K |
| 2023 | $65.88 | $12.40 | 5.31x | $53.48 | $2.2M | 205.6K | 136.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 242.0K | $2.8M | $11.68 | 6.57x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 172.3K | $2.3M | $13.52 | 5.44x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 120.2K | $2.3M | $19.15 | 4.06x |
| 82306 | Vitamin D-3 level | 45.1K | $1.5M | $33.67 | 5.84x |
| 83970 | Parathormone (parathyroid hormone) level | 31.9K | $1.5M | $46.78 | 4.62x |
| 84153 | PSA (prostate specific antigen) measurement | 59.2K | $1.2M | $19.72 | 4.73x |
| 83036 | Hemoglobin A1C level | 101.7K | $1.1M | $11.28 | 5.23x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 100.6K | $890.9K | $8.86 | 5.89x |
| 80048 | Blood test, basic group of blood chemicals | 95.9K | $880.2K | $9.18 | 5.78x |
| 80069 | Kidney function blood test panel | 74.5K | $726.2K | $9.75 | 5.87x |
| 36415 | Insertion of needle into vein for collection of blood sample | 189.4K | $640.3K | $3.38 | 7.10x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 25.6K | $521.6K | $20.34 | 4.32x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 26.1K | $443.0K | $17.00 | 4.53x |
| 82565 | Blood creatinine level | 80.2K | $411.2K | $5.13 | 3.70x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 9.9K | $404.6K | $40.86 | 2.62x |
| 82570 | Creatinine level to test for kidney function or muscle injury | 68.9K | $388.6K | $5.64 | 4.08x |
| 82043 | Urine microalbumin (protein) level | 51.2K | $340.1K | $6.64 | 10.87x |
| 82728 | Ferritin (blood protein) level | 21.6K | $326.8K | $15.10 | 4.66x |
| 84403 | Testosterone (hormone) level | 8.7K | $258.7K | $29.81 | 4.31x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 31.7K | $231.4K | $7.30 | 6.83x |
This provider submits charges 5.27 times higher than what Medicare actually pays.
A markup ratio of 5.27x means for every $100 Medicare pays, this provider initially charges $527. This is higher than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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