86235
Nuclear antigen antibody (ENA) blood test
Nuclear antigen antibody (ENA) blood test is the #851 most-billed Medicaid procedure code, with $67.8M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $28.79. Costs vary widely — the 90th percentile is $78.91 per claim, 2.7× the median.
Total Paid
$67.8M
0.01% of all spending
Total Claims
2.2M
Providers
778
Avg Cost/Claim
$31
National Cost Distribution
How much do providers bill per claim for 86235? Based on 724 providers billing this code nationally.
Median
$28.79
Average
$38.31
Std Dev
$43.88
Max
$556.27
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.59 and $50.47 per claim for this code.
90% bill between $5.32 and $78.91.
Top 1% bill above $172.45.
About This Procedure
HCPCS code 86235 (Nuclear antigen antibody (ENA) blood test) was billed by 778 providers across 2.2M claims, totaling $67.8M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$28.79
Providers Billing
724
National Spending
$67.8M
Avg/Median Ratio
1.33×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86235
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $5.8M |
| 2 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $4.1M |
| 3 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $3.7M |
| 4 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $3.0M |
| 5 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $2.2M |
| 6 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $1.8M |
| 7 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $1.6M |
| 8 | Permanente Medical Group Inc. Berkeley, CA · Clinical Medical Laboratory | $1.5M |
| 9 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $1.4M |
| 10 | Laboratory Corporation Of America Phoenix, AZ · Clinical Medical Laboratory | $1.3M |
| 11 | 1235186800 | $1.2M |
| 12 | Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory | $1.1M |
| 13 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $1.1M |
| 14 | Laboratory Corporation Of America San Diego, CA · Clinical Medical Laboratory | $1.1M |
| 15 | 1245494517 | $1.1M |
| 16 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $1.1M |
| 17 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $1.0M |
| 18 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $957K |
| 19 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $925K |
| 20 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $860K |
Showing top 20 of 778 providers billing this code