This provider's $3.2M in total Medicare payments ranks in the 70th 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 | $36.17 | $34.31 | 1.05x | $1.86 | $436.4K | 34.7K | 20.7K |
| 2015 | $34.02 | $32.17 | 1.06x | $1.85 | $468.0K | 35.3K | 20.7K |
| 2016 | $36.75 | $34.95 | 1.05x | $1.80 | $474.9K | 35.2K | 20.7K |
| 2017 | $38.72 | $36.82 | 1.05x | $1.90 | $339.7K | 24.7K | 16.6K |
| 2018 | $17.48 | $16.87 | 1.04x | $0.61 | $246.2K | 22.1K | 14.3K |
| 2019 | $31.03 | $30.36 | 1.02x | $0.67 | $316.2K | 26.5K | 16.4K |
| 2020 | $15.92 | $15.62 | 1.02x | $0.30 | $242.0K | 20.8K | 13.7K |
| 2021 | $18.32 | $18.10 | 1.01x | $0.22 | $252.8K | 23.2K | 13.8K |
| 2022 | $15.22 | $14.94 | 1.02x | $0.28 | $211.9K | 21.0K | 12.6K |
| 2023 | $14.96 | $14.58 | 1.03x | $0.38 | $219.7K | 21.1K | 12.4K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 15.1K | $298.4K | $19.82 | 1.02x |
| 80053 | Blood test, comprehensive group of blood chemicals | 23.7K | $267.2K | $11.26 | 1.15x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 18.6K | $258.0K | $13.85 | 1.17x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 27.4K | $254.2K | $9.28 | 1.02x |
| 82306 | Vitamin D-3 level | 6.8K | $237.6K | $34.73 | 1.02x |
| 36415 | Insertion of needle into vein for collection of blood sample | 40.8K | $131.4K | $3.22 | 1.04x |
| 83036 | Hemoglobin A1C level | 9.8K | $111.6K | $11.42 | 1.02x |
| 81162 | Gene analysis (breast cancer 1 and 2) full sequence and duplication or deletion variants | 42 | $94.4K | $2.2K | 1.02x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 3.6K | $63.1K | $17.68 | 1.02x |
| 84153 | PSA (prostate specific antigen) measurement | 2.9K | $62.7K | $21.72 | 1.02x |
| 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 | 656 | $58.5K | $89.19 | 1.10x |
| 81003 | Automated urinalysis test | 19.9K | $53.0K | $2.66 | 1.02x |
| 81211 | Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants | 25 | $52.1K | $2.1K | 1.03x |
| 83970 | Parathormone (parathyroid hormone) level | 1.0K | $47.3K | $47.14 | 1.02x |
| 84439 | Thyroxine (thyroid chemical) measurement | 4.3K | $44.6K | $10.48 | 1.02x |
| 87086 | Bacterial colony count, urine | 4.4K | $41.3K | $9.49 | 1.02x |
| 80197 | Tacrolimus level | 2.3K | $39.4K | $17.43 | 1.02x |
| 82043 | Urine microalbumin (protein) level | 5.6K | $37.9K | $6.75 | 1.02x |
| 87536 | Detection test for HIV-1 virus | 353 | $32.9K | $93.21 | 1.15x |
| 84436 | Thyroxine (thyroid chemical) measurement | 3.4K | $28.2K | $8.32 | 1.02x |
This provider submits charges 1.06 times higher than what Medicare actually pays.
A markup ratio of 1.06x means for every $100 Medicare pays, this provider initially charges $106. 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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