Quest Diagnostics LLC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: 81401 at 4.3× median, 87800 at 2.5× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Compared to Clinical Medical Laboratory Peers
Total spending distribution among 88 providers in this specialty
This provider's total spending of $209.7M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$209.7M
$209,742,564
Total Claims
45.9M
Beneficiaries
41.3M
1.1 claims/patient
Avg Cost/Claim
$5
#420 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Quest Diagnostics LLC is a Clinical Medical Laboratory provider based in Marlborough, MA. From the 2018–2024 period, this provider received $209.7M in Medicaid payments across 45.9M claims.
Why This Matters
This provider received $209.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,217 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (80307 (Drug test, presumptive, by chemistry analyzers)) accounts for 16% of total spending.
$33.0M
1.2M claims
$27.43
$35.43
Drug test, presumptive, by chemistry analyzers
$33.0M
1.2M claims · 15.8%
$30.1M
577K claims
$52.19
$63.08
Infectious disease detection (COVID-19)
$30.1M
577K claims · 14.4%
$19.2M
951K claims
$20.18
$37.56
Drug test, definitive, 1-7 drug classes
$19.2M
951K claims · 9.1%
$7.1M
83K claims · 3.4%
$6.0M
522K claims
$11.41
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$6.0M
522K claims · 2.8%
$6.0M
522K claims
$11.41
$24.95
Chlamydia detection, nucleic acid, amplified probe
$6.0M
522K claims · 2.8%
Vitamin D, 25 hydroxy
$5.3M
526K claims · 2.5%
$5.2M
520K claims
$10.05
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$5.2M
520K claims · 2.5%
$4.5M
134K claims
$33.27
$38.35
Tuberculosis test, cell-mediated immunity
$4.5M
134K claims · 2.1%
Thyroid stimulating hormone (TSH)
$4.2M
1.1M claims · 2.0%
$4.0M
91K claims
$44.38
$38.79
Infectious agent detection, amplified probe, multiple organisms
$4.0M
91K claims · 1.9%
$3.7M
201K claims
$18.40
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$3.7M
201K claims · 1.8%
$3.3M
866K claims
$3.76
$5.50
Hemoglobin A1c (glycated hemoglobin)
$3.3M
866K claims · 1.6%
$2.6M
1.3M claims
$2.01
$4.71
Complete blood count (CBC) with differential, automated
$2.6M
1.3M claims · 1.3%
$2.5M
58K claims · 1.2%
Hepatitis C antibody
$2.3M
402K claims · 1.1%
$2.2M
119K claims
$18.67
$25.57
HPV detection, high-risk types, nucleic acid
$2.2M
119K claims · 1.1%
$2.1M
2.4M claims
$0.90
$1.57
Collection of venous blood by venipuncture
$2.1M
2.4M claims · 1.0%
$2.1M
153K claims
$13.87
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$2.1M
153K claims · 1.0%
$2.0M
58K claims · 1.0%
Cyanocobalamin (vitamin B-12)
$1.7M
343K claims · 0.8%
$1.5M
377K claims
$4.03
$5.31
Urine culture, colony count, with identification
$1.5M
377K claims · 0.7%
$1.5M
220K claims · 0.7%
$1.4M
58K claims · 0.6%
$1.3M
1.1M claims · 0.6%
$1.2M
11K claims
$106.44
$97.61
Respiratory virus detection, 6-11 targets, nucleic acid
$1.2M
11K claims · 0.6%
$1.2M
57K claims
$20.53
$15.76
Infectious disease detection, COVID-19, antigen
$1.2M
57K claims · 0.6%
$1.2M
2K claims
$560.81
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$1.2M
2K claims · 0.5%
$1.1M
1.1M claims · 0.5%
$1.1M
1.1M claims · 0.5%
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