Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

IBD-10

Facility

$32.47

Hospital Charge Code	3101559
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-11

Facility

$32.47

Hospital Charge Code	3101560
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-12

Facility

$32.47

Hospital Charge Code	3101561
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-13

Facility

$32.47

Hospital Charge Code	3101562
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-14

Facility

$32.47

Hospital Charge Code	3101563
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-15

Facility

$32.47

Hospital Charge Code	3101564
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-16

Facility

$32.47

Hospital Charge Code	3101565
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-17

Facility

$32.48

Hospital Charge Code	3101566
Hospital Revenue Code	300
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$27.61
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.61
Rate for Payer: Priority Health Commercial	$22.74
Rate for Payer: Priority Health PPO	$22.74

IBD-2

Facility

$32.47

Hospital Charge Code	3101551
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-3

Facility

$32.47

Hospital Charge Code	3101552
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-4

Facility

$32.47

Hospital Charge Code	3101553
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-5

Facility

$32.47

Hospital Charge Code	3101554
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-6

Facility

$32.47

Hospital Charge Code	3101555
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-7

Facility

$32.47

Hospital Charge Code	3101556
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-8

Facility

$32.47

Hospital Charge Code	3101557
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD-9

Facility

$32.47

Hospital Charge Code	3101558
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

IBD DIAGNOSTIC

Facility

$623.00

Hospital Charge Code	3000824
Hospital Revenue Code	301
Min. Negotiated Rate	$436.10
Max. Negotiated Rate	$529.55
Rate for Payer: Cash Price	$404.95
Rate for Payer: Community Health Alliance Commercial	$529.55
Rate for Payer: Priority Health Commercial	$436.10
Rate for Payer: Priority Health PPO	$436.10

IBDP-1

Facility

$3.48

Hospital Charge Code	3101794
Hospital Revenue Code	300
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.96
Rate for Payer: Cash Price	$2.26
Rate for Payer: Community Health Alliance Commercial	$2.96
Rate for Payer: Priority Health Commercial	$2.44
Rate for Payer: Priority Health PPO	$2.44

IBDP-2

Facility

$3.48

Hospital Charge Code	3101795
Hospital Revenue Code	300
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.96
Rate for Payer: Cash Price	$2.26
Rate for Payer: Community Health Alliance Commercial	$2.96
Rate for Payer: Priority Health Commercial	$2.44
Rate for Payer: Priority Health PPO	$2.44

IBDP-3

Facility

$3.48

Hospital Charge Code	3101796
Hospital Revenue Code	300
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.96
Rate for Payer: Cash Price	$2.26
Rate for Payer: Community Health Alliance Commercial	$2.96
Rate for Payer: Priority Health Commercial	$2.44
Rate for Payer: Priority Health PPO	$2.44

IBDP-4

Facility

$3.48

Hospital Charge Code	3102330
Hospital Revenue Code	300
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.96
Rate for Payer: Cash Price	$2.26
Rate for Payer: Community Health Alliance Commercial	$2.96
Rate for Payer: Priority Health Commercial	$2.44
Rate for Payer: Priority Health PPO	$2.44

IBDP-5

Facility

$3.49

Hospital Charge Code	3102331
Hospital Revenue Code	300
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.97
Rate for Payer: Cash Price	$2.27
Rate for Payer: Community Health Alliance Commercial	$2.97
Rate for Payer: Priority Health Commercial	$2.44
Rate for Payer: Priority Health PPO	$2.44

IBUPROFIN LEVEL

Facility

$131.00

Hospital Charge Code	3000448
Hospital Revenue Code	301
Min. Negotiated Rate	$91.70
Max. Negotiated Rate	$111.35
Rate for Payer: Cash Price	$85.15
Rate for Payer: Community Health Alliance Commercial	$111.35
Rate for Payer: Priority Health Commercial	$91.70
Rate for Payer: Priority Health PPO	$91.70

ICE MASSAGE

Facility

$42.00

Service Code	HCPCS 97010 GP
Hospital Charge Code	4200025
Hospital Revenue Code	420
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$35.70
Rate for Payer: Cash Price	$27.30
Rate for Payer: Community Health Alliance Commercial	$35.70
Rate for Payer: Priority Health Commercial	$29.40
Rate for Payer: Priority Health PPO	$29.40

ID-1

Facility

$32.58

Hospital Charge Code	3101939
Hospital Revenue Code	300
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$27.69
Rate for Payer: Cash Price	$21.18
Rate for Payer: Community Health Alliance Commercial	$27.69
Rate for Payer: Priority Health Commercial	$22.81
Rate for Payer: Priority Health PPO	$22.81

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges