This provider's $22.9M in total Medicare payments ranks in the 96th 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 | $36.34 | $16.35 | 2.22x | $19.99 | $2.2M | 191.9K | 115.7K |
| 2015 | $38.61 | $16.04 | 2.41x | $22.57 | $2.1M | 181.6K | 110.7K |
| 2016 | $36.95 | $15.95 | 2.32x | $21.00 | $2.2M | 182.2K | 112.2K |
| 2017 | $38.39 | $16.68 | 2.30x | $21.71 | $2.5M | 204.7K | 127.9K |
| 2018 | $37.31 | $16.31 | 2.29x | $21.00 | $2.4M | 198.6K | 127.2K |
| 2019 | $39.83 | $16.50 | 2.41x | $23.33 | $2.2M | 194.7K | 129.4K |
| 2020 | $39.83 | $16.32 | 2.44x | $23.51 | $2.4M | 182.3K | 124.5K |
| 2021 | $36.97 | $15.98 | 2.31x | $20.99 | $2.3M | 189.3K | 130.2K |
| 2022 | $35.92 | $16.59 | 2.17x | $19.33 | $2.4M | 207.8K | 143.0K |
| 2023 | $34.67 | $15.54 | 2.23x | $19.13 | $2.3M | 211.5K | 145.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 234.3K | $2.7M | $11.61 | 2.58x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 112.9K | $2.2M | $19.33 | 1.98x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 115.7K | $1.6M | $14.09 | 2.43x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 188.8K | $1.4M | $7.31 | 2.05x |
| 82306 | Vitamin D-3 level | 32.3K | $1.1M | $34.22 | 2.12x |
| 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 | 10.4K | $905.3K | $87.34 | 1.37x |
| 87086 | Bacterial colony count, urine | 92.0K | $849.8K | $9.24 | 2.71x |
| 80048 | Blood test, basic group of blood chemicals | 88.0K | $843.6K | $9.59 | 2.61x |
| 83036 | Hemoglobin A1C level | 60.3K | $678.2K | $11.24 | 2.18x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 54.5K | $543.9K | $9.97 | 2.47x |
| 87077 | Bacterial culture for aerobic isolates | 56.3K | $522.9K | $9.29 | 2.65x |
| 36415 | Insertion of needle into vein for collection of blood sample | 159.0K | $500.6K | $3.15 | 1.91x |
| 83970 | Parathormone (parathyroid hormone) level | 9.4K | $438.2K | $46.47 | 2.15x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 18.1K | $391.0K | $21.55 | 2.18x |
| 84403 | Testosterone (hormone) level | 13.2K | $385.3K | $29.28 | 1.92x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 21.9K | $379.1K | $17.28 | 2.23x |
| 84439 | Thyroxine (thyroid chemical) measurement | 34.0K | $344.9K | $10.15 | 2.17x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 8.2K | $337.7K | $41.42 | 2.01x |
| 85610 | Blood test, clotting time | 57.5K | $285.2K | $4.96 | 3.03x |
| 84153 | PSA (prostate specific antigen) measurement | 12.1K | $254.7K | $20.99 | 2.09x |
This provider submits charges 2.32 times higher than what Medicare actually pays.
A markup ratio of 2.32x means for every $100 Medicare pays, this provider initially charges $232. 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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