Quest Diagnostics Massachusetts LLC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 12 procedure codes: 0241U at 3.5× median, 81511 at 4.1× 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
▼
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 $199.9M is at the 50th percentile among 88 Clinical Medical Laboratory providers.
Total Paid
$199.9M
$199,858,547
Total Claims
17.5M
Beneficiaries
16.3M
1.1 claims/patient
Avg Cost/Claim
$11
#457 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Quest Diagnostics Massachusetts LLC is a Clinical Medical Laboratory provider based in Marlborough, MA. From the 2018–2024 period, this provider received $199.9M in Medicaid payments across 17.5M claims.
Why This Matters
This provider received $199.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,982 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 (U0003 (Infectious disease detection (COVID-19))) accounts for 13% of total spending.
$25.5M
364K claims
$70.09
$63.08
Infectious disease detection (COVID-19)
$25.5M
364K claims · 12.8%
$21.2M
589K claims
$36.06
$37.56
Drug test, definitive, 1-7 drug classes
$21.2M
589K claims · 10.6%
$17.8M
616K claims
$28.95
$35.43
Drug test, presumptive, by chemistry analyzers
$17.8M
616K claims · 8.9%
$8.6M
463K claims
$18.50
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$8.6M
463K claims · 4.3%
$8.5M
468K claims
$18.24
$24.95
Chlamydia detection, nucleic acid, amplified probe
$8.5M
468K claims · 4.3%
$4.6M
88K claims
$52.62
$38.79
Infectious agent detection, amplified probe, multiple organisms
$4.6M
88K claims · 2.3%
$4.4M
7K claims
$672.84
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$4.4M
7K claims · 2.2%
$3.7M
91K claims
$40.65
$38.35
Tuberculosis test, cell-mediated immunity
$3.7M
91K claims · 1.8%
$3.5M
69K claims · 1.8%
$3.5M
261K claims
$13.51
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$3.5M
261K claims · 1.8%
$3.1M
133K claims
$23.58
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$3.1M
133K claims · 1.6%
$3.1M
141K claims
$21.94
$25.57
HPV detection, high-risk types, nucleic acid
$3.1M
141K claims · 1.5%
Vitamin D, 25 hydroxy
$2.9M
257K claims · 1.5%
$2.7M
135K claims
$19.81
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$2.7M
135K claims · 1.3%
Thyroid stimulating hormone (TSH)
$2.5M
439K claims · 1.3%
CFTR gene analysis, common variants
$2.5M
6K claims · 1.2%
$2.3M
35K claims
$65.95
$40.67
Allergen specific IgE blood test, each allergen
$2.3M
35K claims · 1.2%
General health panel
$2.3M
192K claims · 1.1%
$2.3M
18K claims
$128.64
$97.61
Respiratory virus detection, 6-11 targets, nucleic acid
$2.3M
18K claims · 1.1%
$2.2M
102K claims
$21.61
$15.76
Infectious disease detection, COVID-19, antigen
$2.2M
102K claims · 1.1%
$2.2M
524K claims
$4.16
$5.50
Hemoglobin A1c (glycated hemoglobin)
$2.2M
524K claims · 1.1%
$2.2M
66K claims · 1.1%
Lipid panel
$2.0M
756K claims · 1.0%
$2.0M
711K claims
$2.81
$4.71
Complete blood count (CBC) with differential, automated
$2.0M
711K claims · 1.0%
$1.9M
396K claims
$4.79
$5.31
Urine culture, colony count, with identification
$1.9M
396K claims · 0.9%
Comprehensive metabolic panel
$1.9M
714K claims · 0.9%
$1.9M
51K claims
$37.03
$35.80
Surgical pathology, gross and microscopic examination
$1.9M
51K claims · 0.9%
$1.8M
49K claims · 0.9%
$1.6M
32K claims · 0.8%
Hepatitis C antibody
$1.6M
212K claims · 0.8%
Other Top Providers in Massachusetts
View all →Similar Providers
Other top providers in Clinical Medical Laboratory