Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

IgG, ARBOVIRUS

Facility

$41.00

Service Code	HCPCS 86651
Hospital Charge Code	3005392
Hospital Revenue Code	302
Min. Negotiated Rate	$6.09
Max. Negotiated Rate	$34.85
Rate for Payer: BCBS BCN 65	$13.85
Rate for Payer: Blue Care Network Medicare Advantage	$13.85
Rate for Payer: Cash Price	$26.65
Rate for Payer: Cash Price	$26.65
Rate for Payer: Community Health Alliance Commercial	$34.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$13.85
Rate for Payer: Meridian Health Plan Medicare	$13.85
Rate for Payer: Priority Health Commercial	$28.70
Rate for Payer: Priority Health Medicaid	$13.85
Rate for Payer: Priority Health Medicare	$13.85
Rate for Payer: Priority Health PPO	$28.70
Rate for Payer: United Health Care Medicaid	$13.85
Rate for Payer: United Health Care Medicare Advantage	$6.09

IgG CARDIOLIPIN

Facility

$2.82

Service Code	HCPCS 86147
Hospital Charge Code	3005396
Hospital Revenue Code	302
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$26.72
Rate for Payer: BCBS BCN 65	$26.72
Rate for Payer: Blue Care Network Medicare Advantage	$26.72
Rate for Payer: Cash Price	$1.83
Rate for Payer: Cash Price	$1.83
Rate for Payer: Community Health Alliance Commercial	$2.40
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$26.72
Rate for Payer: Meridian Health Plan Medicare	$26.72
Rate for Payer: Priority Health Commercial	$1.97
Rate for Payer: Priority Health Medicaid	$26.72
Rate for Payer: Priority Health Medicare	$26.72
Rate for Payer: Priority Health PPO	$1.97
Rate for Payer: United Health Care Medicaid	$26.72
Rate for Payer: United Health Care Medicare Advantage	$11.76

IgG FOR ASPERGILLUS PRECIPITIN

Facility

$144.00

Hospital Charge Code	3008010
Hospital Revenue Code	302
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$122.40
Rate for Payer: Cash Price	$93.60
Rate for Payer: Community Health Alliance Commercial	$122.40
Rate for Payer: Priority Health Commercial	$100.80
Rate for Payer: Priority Health PPO	$100.80

IGG,IGA,IGM-EACH

Facility

$5.53

Service Code	HCPCS 82784
Hospital Charge Code	3005400
Hospital Revenue Code	301
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$9.77
Rate for Payer: BCBS BCN 65	$9.77
Rate for Payer: Blue Care Network Medicare Advantage	$9.77
Rate for Payer: Cash Price	$3.59
Rate for Payer: Cash Price	$3.59
Rate for Payer: Community Health Alliance Commercial	$4.70
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$9.77
Rate for Payer: Meridian Health Plan Medicare	$9.77
Rate for Payer: Priority Health Commercial	$3.87
Rate for Payer: Priority Health Medicaid	$9.77
Rate for Payer: Priority Health Medicare	$9.77
Rate for Payer: Priority Health PPO	$3.87
Rate for Payer: United Health Care Medicaid	$9.77
Rate for Payer: United Health Care Medicare Advantage	$4.30

IgG NOCARDIA

Facility

$323.00

Service Code	HCPCS 86744
Hospital Charge Code	3005420
Hospital Revenue Code	302
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$274.55
Rate for Payer: BCBS BCN 65	$16.79
Rate for Payer: Blue Care Network Medicare Advantage	$16.79
Rate for Payer: Cash Price	$209.95
Rate for Payer: Cash Price	$209.95
Rate for Payer: Community Health Alliance Commercial	$274.55
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$16.79
Rate for Payer: Meridian Health Plan Medicare	$16.79
Rate for Payer: Priority Health Commercial	$226.10
Rate for Payer: Priority Health Medicaid	$16.79
Rate for Payer: Priority Health Medicare	$16.79
Rate for Payer: Priority Health PPO	$226.10
Rate for Payer: United Health Care Medicaid	$16.79
Rate for Payer: United Health Care Medicare Advantage	$7.39

IGG-SERUM

Facility

$28.00

Service Code	HCPCS 82784
Hospital Charge Code	3005401
Hospital Revenue Code	301
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$23.80
Rate for Payer: BCBS BCN 65	$9.77
Rate for Payer: Blue Care Network Medicare Advantage	$9.77
Rate for Payer: Cash Price	$18.20
Rate for Payer: Cash Price	$18.20
Rate for Payer: Community Health Alliance Commercial	$23.80
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$9.77
Rate for Payer: Meridian Health Plan Medicare	$9.77
Rate for Payer: Priority Health Commercial	$19.60
Rate for Payer: Priority Health Medicaid	$9.77
Rate for Payer: Priority Health Medicare	$9.77
Rate for Payer: Priority Health PPO	$19.60
Rate for Payer: United Health Care Medicaid	$9.77
Rate for Payer: United Health Care Medicare Advantage	$4.30

IGG SUBCLASS

Facility

$4.51

Service Code	HCPCS 82787
Hospital Charge Code	3005404
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$8.42
Rate for Payer: BCBS BCN 65	$8.42
Rate for Payer: Blue Care Network Medicare Advantage	$8.42
Rate for Payer: Cash Price	$2.93
Rate for Payer: Cash Price	$2.93
Rate for Payer: Community Health Alliance Commercial	$3.83
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.42
Rate for Payer: Meridian Health Plan Medicare	$8.42
Rate for Payer: Priority Health Commercial	$3.16
Rate for Payer: Priority Health Medicaid	$8.42
Rate for Payer: Priority Health Medicare	$8.42
Rate for Payer: Priority Health PPO	$3.16
Rate for Payer: United Health Care Medicaid	$8.42
Rate for Payer: United Health Care Medicare Advantage	$3.71

IGG SUBCLASS 1

Facility

$10.52

Hospital Charge Code	3101993
Hospital Revenue Code	300
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$8.94
Rate for Payer: Cash Price	$6.84
Rate for Payer: Community Health Alliance Commercial	$8.94
Rate for Payer: Priority Health Commercial	$7.36
Rate for Payer: Priority Health PPO	$7.36

IGG SUBCLASS 2

Facility

$10.52

Hospital Charge Code	3101994
Hospital Revenue Code	300
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$8.94
Rate for Payer: Cash Price	$6.84
Rate for Payer: Community Health Alliance Commercial	$8.94
Rate for Payer: Priority Health Commercial	$7.36
Rate for Payer: Priority Health PPO	$7.36

IGG SUBCLASS 3

Facility

$10.52

Hospital Charge Code	3101995
Hospital Revenue Code	300
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$8.94
Rate for Payer: Cash Price	$6.84
Rate for Payer: Community Health Alliance Commercial	$8.94
Rate for Payer: Priority Health Commercial	$7.36
Rate for Payer: Priority Health PPO	$7.36

IGG SUBCLASS 4

Facility

$10.52

Hospital Charge Code	3101996
Hospital Revenue Code	300
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$8.94
Rate for Payer: Cash Price	$6.84
Rate for Payer: Community Health Alliance Commercial	$8.94
Rate for Payer: Priority Health Commercial	$7.36
Rate for Payer: Priority Health PPO	$7.36

IGG SUBCLASSES-2

Facility

$4.51

Hospital Charge Code	3101989
Hospital Revenue Code	300
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.83
Rate for Payer: Cash Price	$2.93
Rate for Payer: Community Health Alliance Commercial	$3.83
Rate for Payer: Priority Health Commercial	$3.16
Rate for Payer: Priority Health PPO	$3.16

IGG SUBCLASSES-3

Facility

$4.51

Hospital Charge Code	3101990
Hospital Revenue Code	300
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.83
Rate for Payer: Cash Price	$2.93
Rate for Payer: Community Health Alliance Commercial	$3.83
Rate for Payer: Priority Health Commercial	$3.16
Rate for Payer: Priority Health PPO	$3.16

IGG SUBCLASSES-4

Facility

$4.51

Hospital Charge Code	3101991
Hospital Revenue Code	300
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.83
Rate for Payer: Cash Price	$2.93
Rate for Payer: Community Health Alliance Commercial	$3.83
Rate for Payer: Priority Health Commercial	$3.16
Rate for Payer: Priority Health PPO	$3.16

IGG SUBCLASSES IGG PROFILE

Facility

$4.52

Hospital Charge Code	3101992
Hospital Revenue Code	300
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.84
Rate for Payer: Cash Price	$2.94
Rate for Payer: Community Health Alliance Commercial	$3.84
Rate for Payer: Priority Health Commercial	$3.16
Rate for Payer: Priority Health PPO	$3.16

IGH/BCL2t(14;18) TRANS FISH TC

Facility

$120.66

Hospital Charge Code	3101231
Hospital Revenue Code	310
Min. Negotiated Rate	$84.46
Max. Negotiated Rate	$102.56
Rate for Payer: Cash Price	$78.43
Rate for Payer: Community Health Alliance Commercial	$102.56
Rate for Payer: Priority Health Commercial	$84.46
Rate for Payer: Priority Health PPO	$84.46

IGH/BCL2 TRANSLOCATION BY FISH

Facility

$357.00

Hospital Charge Code	3100125
Hospital Revenue Code	310
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$303.45
Rate for Payer: Cash Price	$232.05
Rate for Payer: Community Health Alliance Commercial	$303.45
Rate for Payer: Priority Health Commercial	$249.90
Rate for Payer: Priority Health PPO	$249.90

IGH REARRANGE AMP METH

Facility

$202.00

Hospital Charge Code	3100689
Hospital Revenue Code	300
Min. Negotiated Rate	$141.40
Max. Negotiated Rate	$171.70
Rate for Payer: Cash Price	$131.30
Rate for Payer: Community Health Alliance Commercial	$171.70
Rate for Payer: Priority Health Commercial	$141.40
Rate for Payer: Priority Health PPO	$141.40

IGK REARRANGEABN CLONAL PAP

Facility

$44.00

Hospital Charge Code	3100688
Hospital Revenue Code	300
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$37.40
Rate for Payer: Cash Price	$28.60
Rate for Payer: Community Health Alliance Commercial	$37.40
Rate for Payer: Priority Health Commercial	$30.80
Rate for Payer: Priority Health PPO	$30.80

IGM

Facility

$40.00

Service Code	HCPCS 82784
Hospital Charge Code	3005403
Hospital Revenue Code	301
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$34.00
Rate for Payer: BCBS BCN 65	$9.77
Rate for Payer: Blue Care Network Medicare Advantage	$9.77
Rate for Payer: Cash Price	$26.00
Rate for Payer: Cash Price	$26.00
Rate for Payer: Community Health Alliance Commercial	$34.00
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$9.77
Rate for Payer: Meridian Health Plan Medicare	$9.77
Rate for Payer: Priority Health Commercial	$28.00
Rate for Payer: Priority Health Medicaid	$9.77
Rate for Payer: Priority Health Medicare	$9.77
Rate for Payer: Priority Health PPO	$28.00
Rate for Payer: United Health Care Medicaid	$9.77
Rate for Payer: United Health Care Medicare Advantage	$4.30

IgM, ARBOVIRUS

Facility

$41.00

Service Code	HCPCS 86651
Hospital Charge Code	3005393
Hospital Revenue Code	302
Min. Negotiated Rate	$6.09
Max. Negotiated Rate	$34.85
Rate for Payer: BCBS BCN 65	$13.85
Rate for Payer: Blue Care Network Medicare Advantage	$13.85
Rate for Payer: Cash Price	$26.65
Rate for Payer: Cash Price	$26.65
Rate for Payer: Community Health Alliance Commercial	$34.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$13.85
Rate for Payer: Meridian Health Plan Medicare	$13.85
Rate for Payer: Priority Health Commercial	$28.70
Rate for Payer: Priority Health Medicaid	$13.85
Rate for Payer: Priority Health Medicare	$13.85
Rate for Payer: Priority Health PPO	$28.70
Rate for Payer: United Health Care Medicaid	$13.85
Rate for Payer: United Health Care Medicare Advantage	$6.09

IgM CARDIOLIPIN

Facility

$2.82

Service Code	HCPCS 86147
Hospital Charge Code	3005397
Hospital Revenue Code	302
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$26.72
Rate for Payer: BCBS BCN 65	$26.72
Rate for Payer: Blue Care Network Medicare Advantage	$26.72
Rate for Payer: Cash Price	$1.83
Rate for Payer: Cash Price	$1.83
Rate for Payer: Community Health Alliance Commercial	$2.40
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$26.72
Rate for Payer: Meridian Health Plan Medicare	$26.72
Rate for Payer: Priority Health Commercial	$1.97
Rate for Payer: Priority Health Medicaid	$26.72
Rate for Payer: Priority Health Medicare	$26.72
Rate for Payer: Priority Health PPO	$1.97
Rate for Payer: United Health Care Medicaid	$26.72
Rate for Payer: United Health Care Medicare Advantage	$11.76

IGM SUBCLASS

Facility

$153.00

Service Code	HCPCS 82787
Hospital Charge Code	3005405
Hospital Revenue Code	301
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$130.05
Rate for Payer: BCBS BCN 65	$8.42
Rate for Payer: Blue Care Network Medicare Advantage	$8.42
Rate for Payer: Cash Price	$99.45
Rate for Payer: Cash Price	$99.45
Rate for Payer: Community Health Alliance Commercial	$130.05
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.42
Rate for Payer: Meridian Health Plan Medicare	$8.42
Rate for Payer: Priority Health Commercial	$107.10
Rate for Payer: Priority Health Medicaid	$8.42
Rate for Payer: Priority Health Medicare	$8.42
Rate for Payer: Priority Health PPO	$107.10
Rate for Payer: United Health Care Medicaid	$8.42
Rate for Payer: United Health Care Medicare Advantage	$3.71

IHC-1

Facility

$56.88

Hospital Charge Code	31027483
Hospital Revenue Code	300
Min. Negotiated Rate	$39.82
Max. Negotiated Rate	$48.35
Rate for Payer: Cash Price	$36.97
Rate for Payer: Community Health Alliance Commercial	$48.35
Rate for Payer: Priority Health Commercial	$39.82
Rate for Payer: Priority Health PPO	$39.82

IHC 1st AB Stain

Facility

$56.88

Hospital Charge Code	31027472
Hospital Revenue Code	300
Min. Negotiated Rate	$39.82
Max. Negotiated Rate	$48.35
Rate for Payer: Cash Price	$36.97
Rate for Payer: Community Health Alliance Commercial	$48.35
Rate for Payer: Priority Health Commercial	$39.82
Rate for Payer: Priority Health PPO	$39.82

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges