This provider's $23.7M in total Medicare payments ranks in the 96th percentile of Clinical Laboratory providers nationally.
Their average markup ratio of 5.26x 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 | $69.73 | $15.98 | 4.36x | $53.75 | $2.4M | 187.5K | 125.8K |
| 2015 | $69.86 | $16.25 | 4.30x | $53.61 | $2.5M | 194.6K | 131.6K |
| 2016 | $69.26 | $15.80 | 4.38x | $53.46 | $2.5M | 199.2K | 131.9K |
| 2017 | $68.82 | $16.30 | 4.22x | $52.52 | $2.5M | 191.0K | 130.9K |
| 2018 | $69.49 | $15.27 | 4.55x | $54.22 | $2.4M | 189.2K | 129.5K |
| 2019 | $71.88 | $14.43 | 4.98x | $57.45 | $2.1M | 179.7K | 122.0K |
| 2020 | $73.61 | $14.89 | 4.94x | $58.72 | $1.9M | 166.4K | 114.1K |
| 2021 | $79.21 | $16.75 | 4.73x | $62.46 | $2.5M | 180.5K | 120.8K |
| 2022 | $78.92 | $16.57 | 4.76x | $62.35 | $2.9M | 183.4K | 119.3K |
| 2023 | $79.27 | $16.28 | 4.87x | $62.99 | $2.0M | 160.9K | 111.6K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | 247.9K | $2.9M | $11.51 | 6.53x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 108.6K | $2.1M | $19.59 | 5.47x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 120.7K | $1.7M | $14.33 | 7.55x |
| 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 | 20.4K | $1.6M | $75.87 | 1.98x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 169.7K | $1.5M | $9.06 | 5.97x |
| 82306 | Vitamin D-3 level | 42.6K | $1.5M | $34.08 | 4.18x |
| 83036 | Hemoglobin A1C level | 112.5K | $1.3M | $11.19 | 5.37x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 18.1K | $758.1K | $41.84 | 3.37x |
| 80048 | Blood test, basic group of blood chemicals | 72.4K | $704.5K | $9.73 | 5.55x |
| 83970 | Parathormone (parathyroid hormone) level | 13.8K | $654.5K | $47.57 | 3.71x |
| 36415 | Insertion of needle into vein for collection of blood sample | 150.1K | $502.3K | $3.35 | 5.08x |
| 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 | 18.7K | $462.9K | $24.78 | 1.02x |
| 84439 | Thyroxine (thyroid chemical) measurement | 42.3K | $441.5K | $10.44 | 7.11x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 55.5K | $421.0K | $7.59 | 6.21x |
| 84153 | PSA (prostate specific antigen) measurement | 19.0K | $404.8K | $21.31 | 5.08x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 23.0K | $400.1K | $17.41 | 6.33x |
| 87086 | Bacterial colony count, urine | 42.0K | $397.6K | $9.47 | 5.93x |
| 82746 | Folic acid level | 19.5K | $333.0K | $17.09 | 6.27x |
| 83721 | LDL cholesterol level | 27.5K | $319.3K | $11.62 | 4.05x |
| 82728 | Ferritin (blood protein) level | 17.9K | $282.3K | $15.74 | 4.97x |
This provider submits charges 5.26 times higher than what Medicare actually pays.
A markup ratio of 5.26x means for every $100 Medicare pays, this provider initially charges $526. 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.
Other Clinical Laboratory providers in PA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Clinical Laboratories Inc | Norristown, PA | $340.6M | ✓ Clear |
| Quest Diagnostics Of Pennsylvania, Inc. | Pittsburgh, PA | $130.4M | ⚠️ Flagged |
| Health Network Laboratories, Llc | Allentown, PA | $125.3M | ⚠️ Flagged |
| Sma Medical, Inc. | Feasterville, PA | $100.9M | ✓ Clear |
| Interpace Diagnostics Corporation | Pittsburgh, PA | $95.6M | ✓ Clear |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data