This provider's $14.2M in total Medicare payments ranks in the 93th 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 | $63.11 | $21.06 | 3.00x | $42.05 | $1.1M | 91.1K | 59.2K |
| 2015 | $61.62 | $19.81 | 3.11x | $41.81 | $1.1M | 91.6K | 61.9K |
| 2016 | $67.12 | $22.04 | 3.05x | $45.08 | $1.3M | 110.0K | 72.4K |
| 2017 | $65.17 | $23.72 | 2.75x | $41.45 | $1.5M | 123.4K | 81.7K |
| 2018 | $69.13 | $23.72 | 2.91x | $45.41 | $1.7M | 124.8K | 82.8K |
| 2019 | $63.67 | $22.33 | 2.85x | $41.34 | $1.4M | 122.9K | 81.4K |
| 2020 | $70.17 | $23.25 | 3.02x | $46.92 | $1.6M | 112.4K | 75.7K |
| 2021 | $75.22 | $21.60 | 3.48x | $53.62 | $1.7M | 124.7K | 86.1K |
| 2022 | $78.88 | $19.26 | 4.10x | $59.62 | $1.5M | 120.3K | 83.9K |
| 2023 | $87.99 | $20.82 | 4.23x | $67.17 | $1.3M | 112.0K | 78.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 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 | 13.7K | $1.2M | $84.15 | 3.01x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 57.3K | $1.1M | $19.18 | 2.93x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 70.3K | $980.0K | $13.95 | 4.31x |
| 80048 | Blood test, basic group of blood chemicals | 82.3K | $760.0K | $9.23 | 4.46x |
| 36415 | Insertion of needle into vein for collection of blood sample | 194.6K | $672.4K | $3.45 | 2.76x |
| 80053 | Blood test, comprehensive group of blood chemicals | 59.3K | $664.2K | $11.21 | 4.10x |
| 83036 | Hemoglobin A1C level | 58.0K | $642.8K | $11.09 | 4.06x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 56.6K | $500.0K | $8.84 | 3.72x |
| 82306 | Vitamin D-3 level | 12.5K | $420.3K | $33.61 | 2.79x |
| 83970 | Parathormone (parathyroid hormone) level | 9.0K | $419.2K | $46.67 | 3.22x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 14.5K | $306.4K | $21.08 | 3.24x |
| 87507 | Detection test for digestive tract pathogen | 768 | $287.2K | $373.97 | 1.09x |
| 87086 | Bacterial colony count, urine | 29.1K | $273.2K | $9.37 | 3.85x |
| 85610 | Blood test, clotting time | 52.5K | $236.2K | $4.50 | 3.67x |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within | 8.4K | $208.2K | $24.89 | 3.02x |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 4.8K | $183.7K | $38.17 | 1.45x |
| 84439 | Thyroxine (thyroid chemical) measurement | 19.1K | $181.9K | $9.55 | 4.22x |
| 87641 | Detection test for Staphylococcus aureus, methicillin resistant (MRSA bacteria) | 3.4K | $150.0K | $44.21 | 3.40x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 3.5K | $144.7K | $41.59 | 2.56x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 19.5K | $143.1K | $7.34 | 3.56x |
This provider submits charges 3.47 times higher than what Medicare actually pays.
A markup ratio of 3.47x means for every $100 Medicare pays, this provider initially charges $347. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
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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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