NOAH Attachment 1 - Rate Card.pdf
PDF 274 KB Posted
- Contract number
- 505505-W22-SPB0005-00
- Issued by
- Wisconsin
About this file
This is a COVID-19 Testing and Analysis Rate Card (505505-W22-SPB0005-03) for state and local agencies in Wisconsin. The document establishes pricing for COVID-19 testing services across five geographic regions within Wisconsin, covering all 72 counties. The regions are mapped out with Region 1 covering northern counties like Ashland, Barron, and Douglas; Region 2 including western counties such as Adams, Buffalo, and Crawford; Region 3 encompassing central counties like Brown, Calumet, and Door; and Regions 4 and 5 covering southeastern counties including Milwaukee, Dane, Kenosha, and surrounding areas.
The contract provides multiple testing service models with standardized pricing across most regions. Collection services for diagnostic, screening, and outbreak testing are priced at $120.00 per hour with no site fees for Regions 2-5, while Region 1 shows no availability (N/A) for collection services. Laboratory diagnostic testing services offer Standard PCR tests at $100.00 per test and At Home PCR tests at $100.00 per test, with pooled testing options also available. The contract specifies a 24-hour turnaround time for lab-based tests from collection to result. Additional services like saliva testing are noted but pricing details are not specified in the rate card. The document includes provisions for telehealth services, on-site testing, routine testing, and event-based testing activities at varying scales.
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COVID-19 Testing and Analysis Rate Card, 505505-W22-SPB0005-03
Defenitions Lab based - testing done at the lab Point of Care - bedside testing, any diagnostic test that isn't done in the lab. Testing performed as close as possible to the patient. Bed-side testing, near-patient testing, remote testing, mobile testing, rapid diagnostics Diagnostic testing - used to help diagnose a disease or condition.
Trip Fee - for each testing event and location that occurs at a school facility or event.
Community Testing -
Instructions For specimen collection, identify the hourly staff rate and site fees for each testing model in each geographic region where specimen collection and/or testing services are available for Agencies/Campuses. If services are not available for the model and/or region, leave that field blank.
Details and definitions of these testing models are available in Statement of work (SOW) SPB0005 / Addendums / Attachments. For Diagnostic Testing, identify the price per test by test type.
Turn Around Time - Lab-based tests should have a 24 hour turnaround time from collection to result, or or as agreed between Contractor and End User.
Additional Services - any services being offered not specifically mentioned on the pricing sheet but are within the scope of work may be detailed here. If using an attachment to detail additional services use "See Attachement X" Region Map Tab - This is to define the regions referenced on the Pricing Sheet
DocuSign Envelope ID: 9B4A3512-17D5-4161-91B2-300E6E9166FB
Region Model A: Collection Services for Diagnostic Testing Model B: Collection Services for Screening Testing Model C: Collection Services for Outbreak Testing Laboratory Diagnostic Testing Services (See Region Map A1: Telehealth A2: On Site B1: Routine B2: Event/Activity Small scale Large scale Lab-based (24 hours, collect to result) Point of Care
Tab) Hourly Fee Site Fee Hourly Fee Site Fee Hourly Fee Site Fee Hourly Fee Site Fee Hourly fee Site fee Hourly fee Site fee Standard PCR At Home Pooled Standard PCR At Home Region 1 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A $100.00 N/A $100.00 N/A N/A Region 2 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $100.00 N/A $100.00 N/A N/A Region 3 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $100.00 N/A $100.00 N/A N/A Region 4 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $100.00 N/A $100.00 N/A N/A Region 5 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $120.00 $0.00 $100.00 N/A $100.00 N/A N/A
> Service:
> Service:
> Service:
> Service:
*Any services being offered not specifically mentioned on the pricing sheet but are within the scope of work may be detailed here. If using an attachment to detail additional services use "See Attachement X"
COVID-19 Testing Pricing Sheet
Additional Services
Saliva Testing
Company Name:
Date:
Ashland Adams Brown Columbia Kenosha Barron Buffalo Calumet Dane Milwaukee Bayfield Chippewa Door Dodge Ozaukee Burnett Clark Fond du Lac Green Racine Douglas Crawford Green Lake Grant Sheboygan Iron Dunn Kewaunee Iowa Walworth Polk Eau Claire Manitowoc Jefferson Washington Price Jackson Marinette Lafayette Waukesha Rusk Juneau Marquette Richland Sawyer La Crosse Menominee Rock Taylor Marathon Oconto Sauk Washburn Monroe Outagamie Florence Pepin Shawano Forest Pierce Waupaca Langlade Portage Waushara Lincoln St. Croix Winnebago Oneida Trempealeau Vilas Vernon
Wood
Region 1 Region 2 Region 3 Region 4 Region 4
| Instructions |
| Pricing Sheet |
| Region Map |
| 2021-09-28T14:03:58-0700 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .