This provider's $3.6M in total Medicare payments ranks in the 74th 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 | $53.15 | $16.41 | 3.24x | $36.74 | $532.1K | 43.9K | 28.8K |
| 2015 | $51.40 | $16.66 | 3.09x | $34.74 | $441.9K | 36.4K | 25.0K |
| 2016 | $50.98 | $17.08 | 2.98x | $33.90 | $373.1K | 30.5K | 20.5K |
| 2017 | $52.65 | $17.41 | 3.02x | $35.24 | $361.5K | 29.0K | 18.9K |
| 2018 | $57.77 | $20.40 | 2.83x | $37.37 | $369.7K | 29.5K | 19.3K |
| 2019 | $56.36 | $16.46 | 3.42x | $39.90 | $318.8K | 29.1K | 19.2K |
| 2020 | $59.28 | $15.37 | 3.86x | $43.91 | $355.8K | 30.4K | 20.3K |
| 2021 | $59.71 | $15.60 | 3.83x | $44.11 | $337.1K | 28.1K | 19.9K |
| 2022 | $64.05 | $16.21 | 3.95x | $47.84 | $258.7K | 20.5K | 14.8K |
| 2023 | $66.15 | $15.90 | 4.16x | $50.25 | $288.9K | 21.5K | 15.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 82306 | Vitamin D-3 level | 9.6K | $330.1K | $34.42 | 3.09x |
| 84443 | Blood test, thyroid stimulating hormone (TSH) | 12.1K | $237.3K | $19.69 | 2.80x |
| 83970 | Parathormone (parathyroid hormone) level | 4.2K | $198.6K | $47.76 | 2.98x |
| 87086 | Bacterial colony count, urine | 15.3K | $145.4K | $9.51 | 3.21x |
| 80053 | Blood test, comprehensive group of blood chemicals | 11.2K | $128.3K | $11.42 | 2.93x |
| 36415 | Insertion of needle into vein for collection of blood sample | 37.0K | $117.8K | $3.18 | 5.49x |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 7.9K | $112.7K | $14.34 | 3.51x |
| 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 | 1.3K | $110.5K | $84.71 | 1.65x |
| 82607 | Cyanocobalamin (vitamin B-12) level | 5.9K | $105.2K | $17.97 | 3.24x |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test | 10.8K | $97.8K | $9.09 | 2.93x |
| 87077 | Bacterial culture for aerobic isolates | 9.7K | $92.2K | $9.50 | 5.40x |
| 87186 | Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) | 9.0K | $91.2K | $10.16 | 3.12x |
| 80048 | Blood test, basic group of blood chemicals | 8.6K | $80.9K | $9.36 | 3.13x |
| 83036 | Hemoglobin A1C level | 6.9K | $78.0K | $11.27 | 3.09x |
| 85610 | Blood test, clotting time | 13.7K | $66.4K | $4.86 | 4.24x |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | 1.5K | $63.2K | $42.08 | 2.75x |
| 84439 | Thyroxine (thyroid chemical) measurement | 6.3K | $59.0K | $9.42 | 3.10x |
| 87493 | Detection test for clostridium difficile | 1.1K | $46.5K | $42.66 | 2.05x |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 1.9K | $39.2K | $21.20 | 3.30x |
| G0472 | Hepatitis c antibody screening, for individual at high risk and other covered indication(s) | 925 | $38.4K | $41.48 | 1.81x |
This provider submits charges 3.39 times higher than what Medicare actually pays.
A markup ratio of 3.39x means for every $100 Medicare pays, this provider initially charges $339. 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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