This provider's $16.8M in total Medicare payments ranks in the 94th 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 | $86.87 | $16.81 | 5.17x | $70.06 | $1.4M | 134.0K | 75.8K |
| 2015 | $76.95 | $17.11 | 4.50x | $59.84 | $1.4M | 125.8K | 72.5K |
| 2016 | $91.58 | $23.14 | 3.96x | $68.44 | $1.5M | 129.6K | 76.9K |
| 2017 | $94.04 | $23.61 | 3.98x | $70.43 | $1.8M | 147.6K | 91.0K |
| 2018 | $112.89 | $26.66 | 4.23x | $86.23 | $1.8M | 145.6K | 91.2K |
| 2019 | $120.05 | $26.02 | 4.61x | $94.03 | $1.6M | 145.1K | 90.7K |
| 2020 | $105.65 | $20.28 | 5.21x | $85.37 | $2.4M | 142.2K | 91.5K |
| 2021 | $114.24 | $22.40 | 5.10x | $91.84 | $1.7M | 139.4K | 90.3K |
| 2022 | $121.41 | $24.82 | 4.89x | $96.59 | $1.5M | 128.8K | 84.6K |
| 2023 | $110.98 | $21.53 | 5.15x | $89.45 | $1.7M | 153.0K | 100.6K |
| 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 | 14.2K | $1.3M | $92.72 | 1.72x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 59.7K | $1.2M | $19.68 | 5.02x |
| 80053 | Blood test, comprehensive group of blood chemicals | 91.3K | $1.0M | $11.38 | 5.82x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 73.8K | $1.0M | $13.88 | 5.89x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 100.6K | $898.5K | $8.93 | 5.25x |
| 82306 | Vitamin D-3 level | 24.6K | $839.1K | $34.17 | 5.13x |
| 36415 | Insertion of needle into vein for collection of blood sample | 205.5K | $721.1K | $3.51 | 3.70x |
| 83970 | Parathormone (parathyroid hormone) level | 12.8K | $595.4K | $46.40 | 5.29x |
| 80048 | Blood test, basic group of blood chemicals | 63.2K | $591.9K | $9.37 | 5.74x |
| 83036 | Hemoglobin A1C level | 45.5K | $503.8K | $11.09 | 5.01x |
| 87086 | Bacterial colony count, urine | 40.1K | $374.8K | $9.34 | 5.13x |
| 85610 | Blood test, clotting time | 69.0K | $333.5K | $4.83 | 5.34x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 6.9K | $285.3K | $41.46 | 4.87x |
| 84439 | Thyroxine (thyroid chemical) measurement | 27.4K | $258.7K | $9.44 | 7.76x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 24.1K | $240.1K | $9.97 | 5.00x |
| 87077 | Bacterial culture for aerobic isolates | 25.4K | $234.2K | $9.23 | 7.63x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 12.1K | $205.6K | $17.00 | 5.32x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 9.1K | $197.9K | $21.73 | 4.42x |
| 84153 | PSA (prostate specific antigen) measurement | 8.0K | $170.6K | $21.37 | 5.06x |
| 87507 | Detection test for digestive tract pathogen | 315 | $162.5K | $515.74 | 2.22x |
This provider submits charges 4.95 times higher than what Medicare actually pays.
A markup ratio of 4.95x means for every $100 Medicare pays, this provider initially charges $495. This is higher 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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