Quest Diagnostics LLC IL
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 11 procedure codes: 86769 at 1.6× median, 86747 at 2.2× 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 $429.8M is at the 90th percentile among 88 Clinical Medical Laboratory providers.
Above 90th percentile for this specialty — higher spending than 79 of 88 peers
Total Paid
$429.8M
$429,837,134
Total Claims
29.3M
Beneficiaries
26.9M
1.1 claims/patient
Avg Cost/Claim
$15
#146 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Quest Diagnostics LLC IL is a Clinical Medical Laboratory provider based in Wood Dale, IL. From the 2018–2024 period, this provider received $429.8M in Medicaid payments across 29.3M claims.
Why This Matters
This provider received $429.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 53,729 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 (G0480 (Drug test, definitive, 1-7 drug classes)) accounts for 7% of total spending.
$28.9M
505K claims
$57.15
$37.56
Drug test, definitive, 1-7 drug classes
$28.9M
505K claims · 6.7%
$26.8M
364K claims
$73.51
$63.08
Infectious disease detection (COVID-19)
$26.8M
364K claims · 6.2%
$26.0M
681K claims
$38.25
$35.43
Drug test, presumptive, by chemistry analyzers
$26.0M
681K claims · 6.1%
$24.3M
894K claims
$27.24
$24.95
Chlamydia detection, nucleic acid, amplified probe
$24.3M
894K claims · 5.7%
$24.2M
891K claims
$27.20
$23.39
Neisseria gonorrhoeae detection, nucleic acid, amplified probe
$24.2M
891K claims · 5.6%
$20.9M
589K claims
$35.54
$18.03
HIV-1 antigen with HIV-1 and HIV-2 antibodies
$20.9M
589K claims · 4.9%
$14.7M
319K claims
$46.10
$38.79
Infectious agent detection, amplified probe, multiple organisms
$14.7M
319K claims · 3.4%
$14.4M
1.2M claims
$11.53
$9.87
Thyroid stimulating hormone (TSH)
$14.4M
1.2M claims · 3.3%
Comprehensive metabolic panel
$13.0M
1.8M claims · 3.0%
Lipid panel
$11.7M
1.5M claims · 2.7%
Vitamin D, 25 hydroxy
$11.6M
749K claims · 2.7%
$11.5M
533K claims
$21.55
$21.08
Trichomonas vaginalis detection, nucleic acid, amplified probe
$11.5M
533K claims · 2.7%
$11.2M
169K claims · 2.6%
General health panel
$9.9M
228K claims · 2.3%
$8.3M
1.7M claims
$4.86
$4.71
Complete blood count (CBC) with differential, automated
$8.3M
1.7M claims · 1.9%
$7.5M
221K claims · 1.8%
$6.5M
149K claims
$43.82
$38.35
Tuberculosis test, cell-mediated immunity
$6.5M
149K claims · 1.5%
$6.5M
1.1M claims
$5.92
$5.50
Hemoglobin A1c (glycated hemoglobin)
$6.5M
1.1M claims · 1.5%
Hepatitis C antibody
$4.7M
410K claims · 1.1%
$4.6M
86K claims · 1.1%
$4.6M
192K claims
$23.91
$25.57
HPV detection, high-risk types, nucleic acid
$4.6M
192K claims · 1.1%
$4.4M
11K claims
$410.33
$358.21
Fetal chromosomal aneuploidy genomic sequence analysis
$4.4M
11K claims · 1.0%
$4.2M
232K claims
$18.15
$19.06
Cytopathology, cervical or vaginal, ThinPrep
$4.2M
232K claims · 1.0%
$4.2M
648K claims
$6.41
$5.31
Urine culture, colony count, with identification
$4.2M
648K claims · 1.0%
$4.0M
79K claims
$50.59
$40.67
Allergen specific IgE blood test, each allergen
$4.0M
79K claims · 0.9%
$4.0M
1.4M claims
$2.86
$1.57
Collection of venous blood by venipuncture
$4.0M
1.4M claims · 0.9%
$3.6M
42K claims
$85.22
$64.72
Drug test, definitive, 8-14 drug classes
$3.6M
42K claims · 0.8%
$3.5M
513K claims · 0.8%
Cyanocobalamin (vitamin B-12)
$3.4M
358K claims · 0.8%
$3.3M
103K claims · 0.8%
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