86258
HCPCS Procedure Code
HCPCS code 86258 is the #2,717 most-billed Medicaid procedure code, with $4.0M in payments across 361K claims from 2018–2024. The national median cost per claim is $11.19.
Total Paid
$4.0M
0.00% of all spending
Total Claims
361K
Providers
219
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 86258? Based on 210 providers billing this code nationally.
Median
$11.19
Average
$13.29
Std Dev
$10.18
Max
$60.71
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.30 and $16.22 per claim for this code.
90% bill between $3.60 and $20.82.
Top 1% bill above $58.36.
About This Procedure
HCPCS code 86258 was billed by 219 providers across 361K claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 322K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.19
Providers Billing
210
National Spending
$4.0M
Avg/Median Ratio
1.19×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86258
| # | Provider | Total Paid |
|---|---|---|
| 1 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $395K |
| 2 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $342K |
| 3 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $214K |
| 4 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $178K |
| 5 | Laboratory Corporation Of America Holdings Birmingham, AL · Clinical Medical Laboratory | $170K |
| 6 | Laboratory Corporation Of America Holdings Dublin, OH · Clinical Medical Laboratory | $152K |
| 7 | Northwell Health Laboratories New Hyde Park, NY · Clinical Medical Laboratory | $149K |
| 8 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $147K |
| 9 | Sonora Quest Laboratories Llc Phoenix, AZ · Clinical Medical Laboratory | $119K |
| 10 | Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory | $118K |
| 11 | Laboratory Corporation Of America Seattle, WA · Clinical Medical Laboratory | $115K |
| 12 | 1316983158 | $95K |
| 13 | Quest Diagnostics Llc Marlborough, MA · Clinical Medical Laboratory | $82K |
| 14 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $76K |
| 15 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $74K |
| 16 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $74K |
| 17 | Laboratory Corporation Of America Tampa, FL · Clinical Medical Laboratory | $72K |
| 18 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $64K |
| 19 | 1487212551 | $60K |
| 20 | Labone Llc Lenexa, KS · Clinical Medical Laboratory | $60K |
Showing top 20 of 219 providers billing this code