This provider's $71.4M in total Medicare payments ranks in the 99th 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 | $10.51 | $4.15 | 2.53x | $6.36 | $7.6M | 1.8M | 185 |
| 2015 | $11.50 | $4.43 | 2.60x | $7.07 | $9.3M | 2.1M | 179 |
| 2016 | $11.23 | $4.35 | 2.58x | $6.88 | $9.6M | 2.2M | 223 |
| 2017 | $11.41 | $4.46 | 2.56x | $6.95 | $9.6M | 2.1M | 156 |
| 2018 | $11.77 | $4.39 | 2.68x | $7.38 | $8.6M | 2.0M | 155 |
| 2019 | $12.08 | $4.21 | 2.87x | $7.87 | $7.5M | 1.8M | 153 |
| 2020 | $14.24 | $5.12 | 2.78x | $9.12 | $6.4M | 1.2M | 149 |
| 2021 | $13.67 | $4.56 | 3.00x | $9.11 | $4.7M | 1.0M | 138 |
| 2022 | $12.73 | $4.01 | 3.17x | $8.72 | $3.8M | 953.6K | 122 |
| 2023 | $9.17 | $3.13 | 2.93x | $6.04 | $4.3M | 1.4M | 110 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| P9603 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | 9.1M | $8.6M | $0.95 | 1.39x |
| G0471 | Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) | 1.7M | $8.6M | $4.91 | 2.83x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 624.7K | $5.8M | $9.21 | 2.76x |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | 574.8K | $5.7M | $9.99 | 2.84x |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | 198.4K | $4.0M | $19.98 | 2.93x |
| 80053 | Blood test, comprehensive group of blood chemicals | 318.7K | $3.7M | $11.70 | 2.99x |
| 85610 | Blood test, clotting time | 639.1K | $3.2M | $4.96 | 3.59x |
| 82306 | Vitamin d-3 level | 59.0K | $2.1M | $35.10 | 1.97x |
| 87088 | Bacterial urine culture | 209.4K | $2.0M | $9.68 | 2.74x |
| 87086 | Bacterial colony count, urine | 198.2K | $1.9M | $9.76 | 2.72x |
| 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 | 704.8K | $1.9M | $2.71 | 1.14x |
| 83036 | Hemoglobin a1c level | 158.0K | $1.8M | $11.55 | 3.04x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 43.2K | $1.8M | $41.98 | 2.56x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 126.1K | $1.8M | $14.19 | 3.17x |
| 85027 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 196.4K | $1.5M | $7.67 | 3.06x |
| 36415 | Insertion of needle into vein for collection of blood sample | 285.3K | $1.4M | $4.78 | 3.86x |
| 82607 | Cyanocobalamin (vitamin b-12) level | 64.2K | $1.1M | $17.65 | 2.76x |
| 80164 | Valproic acid level, total | 52.1K | $843.3K | $16.20 | 3.13x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution | 78.1K | $818.4K | $10.48 | 2.73x |
| 81001 | Manual urinalysis test with examination using microscope, automated | 200.6K | $767.2K | $3.82 | 4.52x |
This provider submits charges 2.72 times higher than what Medicare actually pays.
A markup ratio of 2.72x means for every $100 Medicare pays, this provider initially charges $272. 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 MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Quest Diagnostics Massachusetts Llc | Marlborough, MA | $276.5M | ⚠️ Flagged |
| Quest Diagnostics Llc | Marlborough, MA | $268.6M | ⚠️ Flagged |
| Foundation Medicine, Inc. | Cambridge, MA | $232.3M | ✓ Clear |
| Boston Heart Diagnostics Corporation | Framingham, MA | $185.1M | ✓ Clear |
| Cohen Dermatopathology, P.C. | Needham, MA | $88.9M | ✓ Clear |
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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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