This provider's $4.1M in total Medicare payments ranks in the 76th percentile of Clinical Laboratory providers nationally.
This provider's billing patterns fall within normal ranges for their specialty.
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 | $16.09 | $15.23 | 1.06x | $0.86 | $465.5K | 42.4K | 23.0K |
| 2015 | $16.01 | $15.20 | 1.05x | $0.81 | $426.0K | 38.4K | 21.0K |
| 2016 | $16.45 | $15.63 | 1.05x | $0.82 | $434.6K | 38.9K | 20.9K |
| 2017 | $16.42 | $15.55 | 1.06x | $0.87 | $436.1K | 38.4K | 22.6K |
| 2018 | $17.24 | $15.28 | 1.13x | $1.96 | $467.2K | 41.7K | 23.7K |
| 2019 | $15.10 | $13.78 | 1.10x | $1.32 | $419.5K | 40.8K | 23.0K |
| 2020 | $14.59 | $14.48 | 1.01x | $0.11 | $422.2K | 38.0K | 23.3K |
| 2021 | $13.69 | $13.66 | 1.00x | $0.03 | $399.0K | 35.6K | 20.7K |
| 2022 | $15.04 | $14.84 | 1.01x | $0.20 | $343.8K | 31.1K | 18.5K |
| 2023 | $13.39 | $13.10 | 1.02x | $0.29 | $270.0K | 25.4K | 14.3K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 24.3K | $478.8K | $19.73 | 1.04x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 29.8K | $415.7K | $13.93 | 1.18x |
| 80053 | Blood test, comprehensive group of blood chemicals | 35.9K | $403.5K | $11.23 | 1.15x |
| 82306 | Vitamin D-3 level | 9.4K | $326.7K | $34.67 | 1.04x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 31.4K | $288.7K | $9.20 | 1.04x |
| 83036 | Hemoglobin A1C level | 17.6K | $199.7K | $11.36 | 1.04x |
| 36415 | Insertion of needle into vein for collection of blood sample | 55.9K | $182.4K | $3.26 | 1.02x |
| 84153 | PSA (prostate specific antigen) measurement | 5.8K | $124.5K | $21.61 | 1.04x |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 1.3K | $110.0K | $83.18 | 1.01x |
| 87088 | Bacterial urine culture | 8.4K | $80.6K | $9.56 | 1.04x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 4.3K | $75.3K | $17.39 | 1.04x |
| 82274 | Stool analysis for blood | 4.0K | $75.0K | $18.66 | 1.04x |
| 84439 | Thyroxine (thyroid chemical) measurement | 6.4K | $67.4K | $10.47 | 1.04x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 8.6K | $64.3K | $7.51 | 1.04x |
| 81001 | Manual urinalysis test with examination using microscope | 17.2K | $58.5K | $3.39 | 1.05x |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge. | 5.9K | $58.4K | $9.85 | 1.02x |
| 81000 | Manual urinalysis test with examination using microscope | 12.3K | $51.9K | $4.23 | 1.02x |
| 83970 | Parathormone (parathyroid hormone) level | 1.0K | $49.1K | $46.90 | 1.04x |
| 84436 | Thyroxine (thyroid chemical) measurement | 5.5K | $44.8K | $8.12 | 1.04x |
| 84479 | Thyroid hormone evaluation | 4.6K | $35.4K | $7.65 | 1.04x |
This provider submits charges 1.07 times higher than what Medicare actually pays.
A markup ratio of 1.07x means for every $100 Medicare pays, this provider initially charges $107. This is lower 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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