This provider's $12.3M in total Medicare payments ranks in the 92th 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 | $272.87 | $93.39 | 2.92x | $179.48 | $903.9K | 16.4K | 14.3K |
| 2015 | $257.76 | $99.62 | 2.59x | $158.14 | $1.1M | 17.6K | 15.5K |
| 2016 | $242.36 | $98.90 | 2.45x | $143.46 | $985.0K | 14.9K | 13.5K |
| 2017 | $235.45 | $90.63 | 2.60x | $144.82 | $1.3M | 20.3K | 18.0K |
| 2018 | $203.56 | $67.14 | 3.03x | $136.42 | $1.4M | 22.8K | 19.9K |
| 2019 | $181.17 | $56.08 | 3.23x | $125.09 | $1.4M | 22.6K | 19.8K |
| 2020 | $210.08 | $68.86 | 3.05x | $141.22 | $1.3M | 19.5K | 16.8K |
| 2021 | $203.76 | $64.44 | 3.16x | $139.32 | $1.4M | 23.8K | 20.4K |
| 2022 | $228.66 | $72.18 | 3.17x | $156.48 | $1.3M | 24.2K | 20.8K |
| 2023 | $237.44 | $72.26 | 3.29x | $165.18 | $1.3M | 24.5K | 21.0K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 120.8K | $7.1M | $58.40 | 3.16x |
| 88112 | Cell examination of specimen | 35.8K | $1.7M | $47.11 | 3.51x |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method, 10-20 specimens | 2.9K | $1.0M | $347.63 | 4.68x |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 6.6K | $519.9K | $78.84 | 1.84x |
| 88342 | Tissue or cell analysis by immunologic technique | 5.7K | $428.5K | $74.54 | 2.48x |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 12.0K | $424.2K | $35.24 | 4.68x |
| 88173 | Evaluation of fine needle aspirate with interpretation and report | 2.4K | $310.3K | $131.04 | 2.20x |
| 88341 | Special stained specimen slides to examine tissue | 3.6K | $247.0K | $67.79 | 2.47x |
| G0124 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician | 7.4K | $230.5K | $31.22 | 2.25x |
| 88141 | Pap test (Pap smear) | 4.3K | $90.6K | $21.25 | 3.30x |
| 88344 | Special stained specimen slides to examine tissue | 609 | $75.2K | $123.40 | 1.44x |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 1.2K | $70.0K | $57.52 | 2.39x |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 275 | $68.2K | $247.84 | 1.34x |
| 88321 | Surgical pathology consultation and report | 409 | $33.6K | $82.15 | 2.81x |
| G0461 | Immunohistochemistry or immunocytochemistry, per specimen; first single or multiplex antibody stain | 343 | $25.7K | $75.00 | 2.66x |
| G0462 | Immunohistochemistry or immunocytochemistry, per specimen; each additional single or multiplex antibody stain (list separately in addition to code for primary procedure) | 216 | $13.1K | $60.58 | 2.82x |
| 88300 | Pathology examination of tissue using a microscope, limited examination | 449 | $6.1K | $13.52 | 6.70x |
| 88160 | Screening examination of specimen cells | 88 | $5.5K | $62.26 | 2.59x |
| 88311 | Preparation of tissue for examination by removing any calcium present | 303 | $5.1K | $16.91 | 3.64x |
| 88302 | Pathology examination of tissue using a microscope | 111 | $2.9K | $26.29 | 4.21x |
This provider submits charges 3.23 times higher than what Medicare actually pays.
A markup ratio of 3.23x means for every $100 Medicare pays, this provider initially charges $323. 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 CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Genomic Health, Inc. | Redwood City, CA | $887.6M | ✓ Clear |
| Unilab Corporation | West Hills, CA | $868.8M | ⚠️ Flagged |
| Caredx Inc. | Brisbane, CA | $751.0M | ✓ Clear |
| Laboratory Corporation Of America | San Diego, CA | $592.4M | ⚠️ Flagged |
| Millennium Health, Llc | San Diego, CA | $587.9M | ✓ 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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