Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

HMWB-3

Facility

$13.05

Hospital Charge Code	3102146
Hospital Revenue Code	300
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$11.09
Rate for Payer: Cash Price	$8.48
Rate for Payer: Community Health Alliance Commercial	$11.09
Rate for Payer: Priority Health Commercial	$9.13
Rate for Payer: Priority Health PPO	$9.13

HMWB-4

Facility

$13.03

Hospital Charge Code	3102147
Hospital Revenue Code	300
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$11.08
Rate for Payer: Cash Price	$8.47
Rate for Payer: Community Health Alliance Commercial	$11.08
Rate for Payer: Priority Health Commercial	$9.12
Rate for Payer: Priority Health PPO	$9.12

HNPCC LYNCH SYNDROME

Facility

$372.00

Service Code	HCPCS G0452
Hospital Charge Code	3100686
Hospital Revenue Code	300
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$316.20
Rate for Payer: Cash Price	$241.80
Rate for Payer: Community Health Alliance Commercial	$316.20
Rate for Payer: Priority Health Commercial	$260.40
Rate for Payer: Priority Health PPO	$260.40

HOFFMAN PIN

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	27018440
Hospital Revenue Code	278
Min. Negotiated Rate	$163.80
Max. Negotiated Rate	$198.90
Rate for Payer: Cash Price	$152.10
Rate for Payer: Community Health Alliance Commercial	$198.90
Rate for Payer: Priority Health Commercial	$163.80
Rate for Payer: Priority Health PPO	$163.80

HOLTER-HOOKUP, FULL DISCLOSURE

Facility

$394.00

Service Code	HCPCS 93225
Hospital Charge Code	7310060
Hospital Revenue Code	731
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$334.90
Rate for Payer: BCBS BCN 65	$142.73
Rate for Payer: Blue Care Network Medicare Advantage	$142.73
Rate for Payer: Cash Price	$256.10
Rate for Payer: Cash Price	$256.10
Rate for Payer: Community Health Alliance Commercial	$334.90
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$142.73
Rate for Payer: Meridian Health Plan Medicare	$142.73
Rate for Payer: Priority Health Commercial	$275.80
Rate for Payer: Priority Health Medicaid	$142.73
Rate for Payer: Priority Health Medicare	$142.73
Rate for Payer: Priority Health PPO	$275.80
Rate for Payer: United Health Care Medicaid	$142.73
Rate for Payer: United Health Care Medicare Advantage	$62.80

HOLTER-SCAN, FULL DISCLOSURE

Facility

$364.00

Service Code	HCPCS 93226
Hospital Charge Code	7310080
Hospital Revenue Code	731
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$309.40
Rate for Payer: BCBS BCN 65	$63.28
Rate for Payer: Blue Care Network Medicare Advantage	$63.28
Rate for Payer: Cash Price	$236.60
Rate for Payer: Cash Price	$236.60
Rate for Payer: Community Health Alliance Commercial	$309.40
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$63.28
Rate for Payer: Meridian Health Plan Medicare	$63.28
Rate for Payer: Priority Health Commercial	$254.80
Rate for Payer: Priority Health Medicaid	$63.28
Rate for Payer: Priority Health Medicare	$63.28
Rate for Payer: Priority Health PPO	$254.80
Rate for Payer: United Health Care Medicaid	$63.28
Rate for Payer: United Health Care Medicare Advantage	$27.84

HOMOCYSTEINE-SE

Facility

$10.00

Service Code	HCPCS 83090
Hospital Charge Code	3009150
Hospital Revenue Code	301
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$18.82
Rate for Payer: BCBS BCN 65	$18.82
Rate for Payer: Blue Care Network Medicare Advantage	$18.82
Rate for Payer: Cash Price	$6.50
Rate for Payer: Cash Price	$6.50
Rate for Payer: Community Health Alliance Commercial	$8.50
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.82
Rate for Payer: Meridian Health Plan Medicare	$18.82
Rate for Payer: Priority Health Commercial	$7.00
Rate for Payer: Priority Health Medicaid	$18.82
Rate for Payer: Priority Health Medicare	$18.82
Rate for Payer: Priority Health PPO	$7.00
Rate for Payer: United Health Care Medicaid	$18.82
Rate for Payer: United Health Care Medicare Advantage	$8.28

HOMOCYSTEINE-URINE

Facility

$40.73

Hospital Charge Code	3009151
Hospital Revenue Code	301
Min. Negotiated Rate	$28.51
Max. Negotiated Rate	$34.62
Rate for Payer: Cash Price	$26.47
Rate for Payer: Community Health Alliance Commercial	$34.62
Rate for Payer: Priority Health Commercial	$28.51
Rate for Payer: Priority Health PPO	$28.51

HOMOVANILLIC ACID,24 HR URINE

Facility

$10.06

Service Code	HCPCS 83150
Hospital Charge Code	3000481
Hospital Revenue Code	301
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$23.53
Rate for Payer: BCBS BCN 65	$23.53
Rate for Payer: Blue Care Network Medicare Advantage	$23.53
Rate for Payer: Cash Price	$6.54
Rate for Payer: Cash Price	$6.54
Rate for Payer: Community Health Alliance Commercial	$8.55
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$23.53
Rate for Payer: Meridian Health Plan Medicare	$23.53
Rate for Payer: Priority Health Commercial	$7.04
Rate for Payer: Priority Health Medicaid	$23.53
Rate for Payer: Priority Health Medicare	$23.53
Rate for Payer: Priority Health PPO	$7.04
Rate for Payer: United Health Care Medicaid	$23.53
Rate for Payer: United Health Care Medicare Advantage	$10.35

HOWELL BILIARY INTRO BRUSH

Facility

$74.00

Hospital Charge Code	27263146
Hospital Revenue Code	272
Min. Negotiated Rate	$51.80
Max. Negotiated Rate	$62.90
Rate for Payer: Cash Price	$48.10
Rate for Payer: Community Health Alliance Commercial	$62.90
Rate for Payer: Priority Health Commercial	$51.80
Rate for Payer: Priority Health PPO	$51.80

HP-1

Facility

$55.23

Hospital Charge Code	3000810
Hospital Revenue Code	306
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-10

Facility

$55.23

Hospital Charge Code	3102200
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-11

Facility

$55.23

Hospital Charge Code	3102201
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-12

Facility

$55.23

Hospital Charge Code	3102202
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-13

Facility

$55.24

Hospital Charge Code	3102203
Hospital Revenue Code	300
Min. Negotiated Rate	$38.67
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.91
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.67
Rate for Payer: Priority Health PPO	$38.67

HP-2

Facility

$55.23

Hospital Charge Code	3000811
Hospital Revenue Code	306
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-3

Facility

$55.23

Hospital Charge Code	3000812
Hospital Revenue Code	306
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-4

Facility

$55.23

Hospital Charge Code	3000813
Hospital Revenue Code	306
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-5

Facility

$55.23

Hospital Charge Code	3102195
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-6

Facility

$55.23

Hospital Charge Code	3102196
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-7

Facility

$55.23

Hospital Charge Code	3102197
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-8

Facility

$55.23

Hospital Charge Code	3102198
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HP-9

Facility

$55.23

Hospital Charge Code	3102199
Hospital Revenue Code	300
Min. Negotiated Rate	$38.66
Max. Negotiated Rate	$46.95
Rate for Payer: Cash Price	$35.90
Rate for Payer: Community Health Alliance Commercial	$46.95
Rate for Payer: Priority Health Commercial	$38.66
Rate for Payer: Priority Health PPO	$38.66

HPV AMPIFIED PROBE

Facility

$45.10

Hospital Charge Code	3007658
Hospital Revenue Code	971
Min. Negotiated Rate	$31.57
Max. Negotiated Rate	$38.34
Rate for Payer: Cash Price	$29.32
Rate for Payer: Community Health Alliance Commercial	$38.34
Rate for Payer: Priority Health Commercial	$31.57
Rate for Payer: Priority Health PPO	$31.57

HPV APTIMA

Facility

$22.00

Hospital Charge Code	3101867
Hospital Revenue Code	300
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$18.70
Rate for Payer: Cash Price	$14.30
Rate for Payer: Community Health Alliance Commercial	$18.70
Rate for Payer: Priority Health Commercial	$15.40
Rate for Payer: Priority Health PPO	$15.40

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges