Hemoglobin separation test by chromatography at Valley County Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HEMOGLOBIN FRACT;CHROMOTO

Ord, NE

See all payers reporting CPT 83021 →

Payers reporting CPT 83021 at Valley County Hospital

Negotiated rates from the hospital’s own file: 8 payers, 20 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	UnitedHealthcare managed medicaid professional · fee schedule · both	$18	$18	—	—	—	$18 – $18
2	Molina managed medicaid/chip professional · fee schedule · both	$19	$19	—	—	—	$19 – $19
3	Molina dual eligible plan professional · fee schedule · both	$19	$19	—	—	—	$19 – $19
4	Bcbs Ne medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$26	$26	$16	64%	—	$9 – $42
5	Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$26	$26	$16	64%	—	$9 – $42
6	UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$26	$26	$16	64%	—	$9 – $42
7	Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$26	$26	$17	64%	—	$10 – $43
8	UnitedHealthcare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$62	$62	$39	64%	—	$23 – $101
9	Molina managed medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges	$66	$66	$42	64%	—	$24 – $109
10	Molina dual eligible plan facility · percent of total billed charges · outpatientfrom % of charges	$68	$68	$43	64%	—	$25 – $111
11	WellCare medicare advantage/dual needs plan facility · percent of total billed charges · outpatientfrom % of charges	$70	$70	$45	64%	—	$26 – $115
12	Medica individual and family business plans facility · percent of total billed charges · inpatientfrom % of charges	$117	$117	$75	64%	—	$43 – $192
13	Medica individual and family business plans facility · percent of total billed charges · outpatientfrom % of charges	$117	$117	$75	64%	—	$43 – $192
14	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$124	$124	$79	64%	—	$45 – $203
15	Bcbs Ne commercial facility · percent of total billed charges · inpatientfrom % of charges	$124	$124	$79	64%	—	$45 – $203
16	Bcbs Ne commercial facility · percent of total billed charges · outpatientfrom % of charges	$124	$124	$79	64%	—	$45 – $203
17	Medica commercial plans/care system products facility · percent of total billed charges · inpatientfrom % of charges	$124	$124	$79	64%	—	$45 – $203
18	Medica commercial plans/care system products facility · percent of total billed charges · outpatientfrom % of charges	$124	$124	$79	64%	—	$45 – $203
19	MultiPlan primary/complementary ppo facility · percent of total billed charges · inpatientfrom % of charges	$126	$126	$80	64%	—	$46 – $207
20	MultiPlan primary/complementary ppo facility · percent of total billed charges · outpatientfrom % of charges	$126	$126	$80	64%	—	$46 – $207