Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Michigan for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Michigan only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Michigan (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Progenity Inc. (NPI 1114222817)

Progenity Inc. is a clinical medical laboratory provider located in Ann Arbor, Michigan. This profile covers 0 Medicare and 51 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Progenity Inc.
Address	5230 S State Rd
City	Ann Arbor
State	MI
ZIP	48108
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	January 11, 2011

Payer Source	Total Paid
Medicaid	$39.6M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	67,910	$190	$13.1M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	53,160	$180	$9.7M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	6,100	$670	$4.1M
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	34,430	$50	$1.5M
81243	The lab analyst performs the technical lab test to detect the presence of changes in the gene for fragile X messenger ribonucleoprotein 1, also known as FMR1, typically to detect common abnormal…	47,740	$20	$1.1M
81255	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for hexosaminidase A [alpha polypeptide], also known as HEXA.	26,000	$40	$987.9K
81251	The lab analyst performs the technical lab test to detect the presence of specific changes in the gene for glucosidase, beta, acid, also known as GBA.	26,170	$40	$941.9K
81200	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for aspartoacylase, also known as ASPA.	22,590	$40	$903.4K
81401	The lab analyst performs the technical lab test to complete one of the specific genetic analyses listed in this Tier 2, Level 2 molecular pathology code.	16,100	$60	$885.7K
81412	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least nine genes that the code descriptor lists, relating to disorders…	1,470	$490	$715.9K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Michigan providers billing the same CPT/HCPCS codes.

Claims Volume vs. Michigan Distribution

Progenity Inc. — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	1	10	160	$180	$2.3M
81443	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least 15 genes, such as the 20 gene examples listed in the code descriptor. The…	1	10	3,360	$610	$2.1M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	1	10	190	$180	$910.5K
81412	The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen for genetic sequences of at least nine genes that the code descriptor lists, relating to disorders…	1	10	1,470	$490	$716.3K
81255	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for hexosaminidase A [alpha polypeptide], also known as HEXA.	1	10	13,890	$40	$605.2K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	1	10	8,780	$40	$597K
81251	The lab analyst performs the technical lab test to detect the presence of specific changes in the gene for glucosidase, beta, acid, also known as GBA.	1	10	14,930	$40	$536.2K
81200	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for aspartoacylase, also known as ASPA.	1	10	13,060	$40	$527.5K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	32	40	1,230	$60	$495.3K
81260	The lab analyst performs the technical lab test to detect the presence of common changes in the gene for inhibitor of kappa light polypeptide gene enhancer in B–cells, kinase complex–associated…	1	10	13,060	$30	$367.7K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moriah, Incorporated	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$48.1M
Joak American Homes, Inc.	MI	Adult Care Home Facility	$0	$37.3M
Huron Valley Ambulance Inc	MI	Ambulance	$6.1M	$27.4M
Aba Pathways, LLC	MI	Behavior Analyst	$0	$31.5M
Jackson Community Ambulance Inc.	MI	Ambulance	$2.2M	$11.7M
Carnegie Adult Foster Care, Inc.	MI	Adult Care Home Facility	$0	$5.6M
Lynx Dx Inc	MI	Clinical Medical Laboratory	$21.5K	$1.7M
Said Issa	MI	Ophthalmology Physician	$139.9K	$505.2K
Louis Bojrab	MI	Interventional Pain Medicine Physician	$185K	$0
Hong Cheng	MI	Anatomic Pathology & Clinical Pathology Physician	$179.3K	$0

Progenity Inc. — Billing Profile & Reimbursement Data

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Progenity Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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References