Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

ANAEROBIC/AEROBOC CUL/GS

Facility

$29.11

Hospital Charge Code	31027380
Hospital Revenue Code	300
Min. Negotiated Rate	$20.38
Max. Negotiated Rate	$24.74
Rate for Payer: Cash Price	$18.92
Rate for Payer: Community Health Alliance Commercial	$24.74
Rate for Payer: Priority Health Commercial	$20.38
Rate for Payer: Priority Health PPO	$20.38

ANAFRANIL

Facility

$13.19

Service Code	HCPCS 80335
Hospital Charge Code	3000510
Hospital Revenue Code	301
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$11.21
Rate for Payer: Cash Price	$8.57
Rate for Payer: Community Health Alliance Commercial	$11.21
Rate for Payer: Priority Health Commercial	$9.23
Rate for Payer: Priority Health PPO	$9.23

ANA IFA WITH REFLUX TO 11 BIOM

Facility

$2.82

Hospital Charge Code	3102538
Hospital Revenue Code	300
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$2.40
Rate for Payer: Cash Price	$1.83
Rate for Payer: Community Health Alliance Commercial	$2.40
Rate for Payer: Priority Health Commercial	$1.97
Rate for Payer: Priority Health PPO	$1.97

ANANEG-1

Facility

$44.50

Hospital Charge Code	3102637
Hospital Revenue Code	300
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$28.93
Rate for Payer: Community Health Alliance Commercial	$37.83
Rate for Payer: Priority Health Commercial	$31.15
Rate for Payer: Priority Health PPO	$31.15

ANANEG-2

Facility

$44.50

Hospital Charge Code	3102638
Hospital Revenue Code	300
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$28.93
Rate for Payer: Community Health Alliance Commercial	$37.83
Rate for Payer: Priority Health Commercial	$31.15
Rate for Payer: Priority Health PPO	$31.15

ANANEG-3

Facility

$44.50

Hospital Charge Code	3102639
Hospital Revenue Code	300
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$37.83
Rate for Payer: Cash Price	$28.93
Rate for Payer: Community Health Alliance Commercial	$37.83
Rate for Payer: Priority Health Commercial	$31.15
Rate for Payer: Priority Health PPO	$31.15

ANAP-1

Facility

$60.66

Hospital Charge Code	3102595
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-10

Facility

$60.66

Hospital Charge Code	3102604
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-11

Facility

$60.66

Hospital Charge Code	3102605
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-12

Facility

$60.66

Hospital Charge Code	3102606
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-13

Facility

$60.66

Hospital Charge Code	3102607
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-14

Facility

$60.66

Hospital Charge Code	3102608
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-15

Facility

$60.76

Hospital Charge Code	3102609
Hospital Revenue Code	300
Min. Negotiated Rate	$42.53
Max. Negotiated Rate	$51.65
Rate for Payer: Cash Price	$39.49
Rate for Payer: Community Health Alliance Commercial	$51.65
Rate for Payer: Priority Health Commercial	$42.53
Rate for Payer: Priority Health PPO	$42.53

ANAP-2

Facility

$60.66

Hospital Charge Code	3102596
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-3

Facility

$60.66

Hospital Charge Code	3102597
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-4

Facility

$60.66

Hospital Charge Code	3102598
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-5

Facility

$60.66

Hospital Charge Code	3102599
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-6

Facility

$60.66

Hospital Charge Code	3102600
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-7

Facility

$60.66

Hospital Charge Code	3102601
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-8

Facility

$60.66

Hospital Charge Code	3102602
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAP-9

Facility

$60.66

Hospital Charge Code	3102603
Hospital Revenue Code	300
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$51.56
Rate for Payer: Cash Price	$39.43
Rate for Payer: Community Health Alliance Commercial	$51.56
Rate for Payer: Priority Health Commercial	$42.46
Rate for Payer: Priority Health PPO	$42.46

ANAPLASMA PHAGOCYTOPHILUM PCR

Facility

$80.00

Hospital Charge Code	3102417
Hospital Revenue Code	300
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$68.00
Rate for Payer: Cash Price	$52.00
Rate for Payer: Community Health Alliance Commercial	$68.00
Rate for Payer: Priority Health Commercial	$56.00
Rate for Payer: Priority Health PPO	$56.00

ANA SCRN W/REFLEX TO MIXED CON

Facility

$12.22

Hospital Charge Code	3101616
Hospital Revenue Code	300
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$10.39
Rate for Payer: Cash Price	$7.94
Rate for Payer: Community Health Alliance Commercial	$10.39
Rate for Payer: Priority Health Commercial	$8.55
Rate for Payer: Priority Health PPO	$8.55

ANA TITER

Facility

$47.00

Hospital Charge Code	3001190
Hospital Revenue Code	302
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$39.95
Rate for Payer: Cash Price	$30.55
Rate for Payer: Community Health Alliance Commercial	$39.95
Rate for Payer: Priority Health Commercial	$32.90
Rate for Payer: Priority Health PPO	$32.90

ANCA-1

Facility

$2.47

Hospital Charge Code	3101669
Hospital Revenue Code	300
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$2.10
Rate for Payer: Cash Price	$1.61
Rate for Payer: Community Health Alliance Commercial	$2.10
Rate for Payer: Priority Health Commercial	$1.73
Rate for Payer: Priority Health PPO	$1.73

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges