Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

KIT, VALVULOTOME #TIVK2030

Facility

$1,155.00

Hospital Charge Code	27267169
Hospital Revenue Code	272
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$981.75
Rate for Payer: Cash Price	$750.75
Rate for Payer: Community Health Alliance Commercial	$981.75
Rate for Payer: Priority Health Commercial	$808.50
Rate for Payer: Priority Health PPO	$808.50

KIT,VARA-PULSE FOR SPRA

Facility

$143.00

Hospital Charge Code	27061121
Hospital Revenue Code	272
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$121.55
Rate for Payer: Cash Price	$92.95
Rate for Payer: Community Health Alliance Commercial	$121.55
Rate for Payer: Priority Health Commercial	$100.10
Rate for Payer: Priority Health PPO	$100.10

KIT,VESICA

Facility

$3,607.00

Service Code	HCPCS C2631
Hospital Charge Code	27022335
Hospital Revenue Code	278
Min. Negotiated Rate	$2,524.90
Max. Negotiated Rate	$3,065.95
Rate for Payer: Cash Price	$2,344.55
Rate for Payer: Community Health Alliance Commercial	$3,065.95
Rate for Payer: Priority Health Commercial	$2,524.90
Rate for Payer: Priority Health PPO	$2,524.90

KIT, VTC NEPHROSTOMY CATHETER

Facility

$823.00

Hospital Charge Code	27264470
Hospital Revenue Code	272
Min. Negotiated Rate	$576.10
Max. Negotiated Rate	$699.55
Rate for Payer: Cash Price	$534.95
Rate for Payer: Community Health Alliance Commercial	$699.55
Rate for Payer: Priority Health Commercial	$576.10
Rate for Payer: Priority Health PPO	$576.10

KIT,WRENCH MEDTRONIC

Facility

$209.00

Hospital Charge Code	27266344
Hospital Revenue Code	272
Min. Negotiated Rate	$146.30
Max. Negotiated Rate	$177.65
Rate for Payer: Cash Price	$135.85
Rate for Payer: Community Health Alliance Commercial	$177.65
Rate for Payer: Priority Health Commercial	$146.30
Rate for Payer: Priority Health PPO	$146.30

KL-1

Facility

$14.00

Hospital Charge Code	3101651
Hospital Revenue Code	300
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$11.90
Rate for Payer: Cash Price	$9.10
Rate for Payer: Community Health Alliance Commercial	$11.90
Rate for Payer: Priority Health Commercial	$9.80
Rate for Payer: Priority Health PPO	$9.80

KL-2

Facility

$14.00

Hospital Charge Code	3101652
Hospital Revenue Code	300
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$11.90
Rate for Payer: Cash Price	$9.10
Rate for Payer: Community Health Alliance Commercial	$11.90
Rate for Payer: Priority Health Commercial	$9.80
Rate for Payer: Priority Health PPO	$9.80

KLEIHAUER-BETKE

Facility

$47.00

Service Code	HCPCS 85460
Hospital Charge Code	3910080
Hospital Revenue Code	300
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$39.95
Rate for Payer: BCBS BCN 65	$8.12
Rate for Payer: Blue Care Network Medicare Advantage	$8.12
Rate for Payer: Cash Price	$30.55
Rate for Payer: Cash Price	$30.55
Rate for Payer: Community Health Alliance Commercial	$39.95
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.12
Rate for Payer: Meridian Health Plan Medicare	$8.12
Rate for Payer: Priority Health Commercial	$32.90
Rate for Payer: Priority Health Medicaid	$8.12
Rate for Payer: Priority Health Medicare	$8.12
Rate for Payer: Priority Health PPO	$32.90
Rate for Payer: United Health Care Medicaid	$8.12
Rate for Payer: United Health Care Medicare Advantage	$3.57

KNEE BRACE W/BUTTRESS PAD LT

Facility

$121.00

Hospital Charge Code	27019976
Hospital Revenue Code	270
Min. Negotiated Rate	$84.70
Max. Negotiated Rate	$102.85
Rate for Payer: Cash Price	$78.65
Rate for Payer: Community Health Alliance Commercial	$102.85
Rate for Payer: Priority Health Commercial	$84.70
Rate for Payer: Priority Health PPO	$84.70

KNEE IMMOBILIZER

Facility

$109.00

Service Code	HCPCS L1830
Hospital Charge Code	27013003
Hospital Revenue Code	274
Min. Negotiated Rate	$76.30
Max. Negotiated Rate	$92.65
Rate for Payer: Cash Price	$70.85
Rate for Payer: Community Health Alliance Commercial	$92.65
Rate for Payer: Priority Health Commercial	$76.30
Rate for Payer: Priority Health PPO	$76.30

KNEE PAD

Facility

$160.00

Hospital Charge Code	27064223
Hospital Revenue Code	270
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$136.00
Rate for Payer: Cash Price	$104.00
Rate for Payer: Community Health Alliance Commercial	$136.00
Rate for Payer: Priority Health Commercial	$112.00
Rate for Payer: Priority Health PPO	$112.00

KNEE SUPPORT

Facility

$26.00

Hospital Charge Code	27063859
Hospital Revenue Code	270
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$22.10
Rate for Payer: Cash Price	$16.90
Rate for Payer: Community Health Alliance Commercial	$22.10
Rate for Payer: Priority Health Commercial	$18.20
Rate for Payer: Priority Health PPO	$18.20

KNIFE,MICRO UNITOME

Facility

$23.00

Hospital Charge Code	27021659
Hospital Revenue Code	272
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$19.55
Rate for Payer: Cash Price	$14.95
Rate for Payer: Community Health Alliance Commercial	$19.55
Rate for Payer: Priority Health Commercial	$16.10
Rate for Payer: Priority Health PPO	$16.10

KNIFE, SERRATED BANANA

Facility

$674.00

Hospital Charge Code	27061511
Hospital Revenue Code	272
Min. Negotiated Rate	$471.80
Max. Negotiated Rate	$572.90
Rate for Payer: Cash Price	$438.10
Rate for Payer: Community Health Alliance Commercial	$572.90
Rate for Payer: Priority Health Commercial	$471.80
Rate for Payer: Priority Health PPO	$471.80

KNOWLES HIP PIN

Facility

$171.00

Hospital Charge Code	27016741
Hospital Revenue Code	278
Min. Negotiated Rate	$119.70
Max. Negotiated Rate	$145.35
Rate for Payer: Cash Price	$111.15
Rate for Payer: Community Health Alliance Commercial	$145.35
Rate for Payer: Priority Health Commercial	$119.70
Rate for Payer: Priority Health PPO	$119.70

KNOWLES HIP PIN

Facility

$164.00

Service Code	HCPCS C1713
Hospital Charge Code	27816741
Hospital Revenue Code	278
Min. Negotiated Rate	$114.80
Max. Negotiated Rate	$139.40
Rate for Payer: Cash Price	$106.60
Rate for Payer: Community Health Alliance Commercial	$139.40
Rate for Payer: Priority Health Commercial	$114.80
Rate for Payer: Priority Health PPO	$114.80

KOH PREP

Facility

$34.00

Service Code	HCPCS 87220
Hospital Charge Code	3005500
Hospital Revenue Code	306
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$28.90
Rate for Payer: BCBS BCN 65	$4.48
Rate for Payer: Blue Care Network Medicare Advantage	$4.48
Rate for Payer: Cash Price	$22.10
Rate for Payer: Cash Price	$22.10
Rate for Payer: Community Health Alliance Commercial	$28.90
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$4.48
Rate for Payer: Meridian Health Plan Medicare	$4.48
Rate for Payer: Priority Health Commercial	$23.80
Rate for Payer: Priority Health Medicaid	$4.48
Rate for Payer: Priority Health Medicare	$4.48
Rate for Payer: Priority Health PPO	$23.80
Rate for Payer: United Health Care Medicaid	$4.48
Rate for Payer: United Health Care Medicare Advantage	$1.97

KOH PREP - RML

Facility

$25.00

Service Code	HCPCS 87220
Hospital Charge Code	3005913
Hospital Revenue Code	306
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$21.25
Rate for Payer: BCBS BCN 65	$4.48
Rate for Payer: Blue Care Network Medicare Advantage	$4.48
Rate for Payer: Cash Price	$16.25
Rate for Payer: Cash Price	$16.25
Rate for Payer: Community Health Alliance Commercial	$21.25
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$4.48
Rate for Payer: Meridian Health Plan Medicare	$4.48
Rate for Payer: Priority Health Commercial	$17.50
Rate for Payer: Priority Health Medicaid	$4.48
Rate for Payer: Priority Health Medicare	$4.48
Rate for Payer: Priority Health PPO	$17.50
Rate for Payer: United Health Care Medicaid	$4.48
Rate for Payer: United Health Care Medicare Advantage	$1.97

KRAS BRAF GENE

Facility

$725.00

Hospital Charge Code	3100698
Hospital Revenue Code	310
Min. Negotiated Rate	$507.50
Max. Negotiated Rate	$616.25
Rate for Payer: Cash Price	$471.25
Rate for Payer: Community Health Alliance Commercial	$616.25
Rate for Payer: Priority Health Commercial	$507.50
Rate for Payer: Priority Health PPO	$507.50

KRAS GENE

Facility

$725.00

Hospital Charge Code	3100675
Hospital Revenue Code	310
Min. Negotiated Rate	$507.50
Max. Negotiated Rate	$616.25
Rate for Payer: Cash Price	$471.25
Rate for Payer: Community Health Alliance Commercial	$616.25
Rate for Payer: Priority Health Commercial	$507.50
Rate for Payer: Priority Health PPO	$507.50

KRAS MUTATION 1

Facility

$131.67

Hospital Charge Code	3101350
Hospital Revenue Code	310
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$111.92
Rate for Payer: Cash Price	$85.59
Rate for Payer: Community Health Alliance Commercial	$111.92
Rate for Payer: Priority Health Commercial	$92.17
Rate for Payer: Priority Health PPO	$92.17

KRAS MUTATION 2

Facility

$131.67

Hospital Charge Code	3101351
Hospital Revenue Code	310
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$111.92
Rate for Payer: Cash Price	$85.59
Rate for Payer: Community Health Alliance Commercial	$111.92
Rate for Payer: Priority Health Commercial	$92.17
Rate for Payer: Priority Health PPO	$92.17

KRAS MUTATION 3

Facility

$131.66

Hospital Charge Code	3101352
Hospital Revenue Code	310
Min. Negotiated Rate	$92.16
Max. Negotiated Rate	$111.91
Rate for Payer: Cash Price	$85.58
Rate for Payer: Community Health Alliance Commercial	$111.91
Rate for Payer: Priority Health Commercial	$92.16
Rate for Payer: Priority Health PPO	$92.16

KRAS MUTATION ANALYSIS

Facility

$197.00

Hospital Charge Code	3100831
Hospital Revenue Code	310
Min. Negotiated Rate	$137.90
Max. Negotiated Rate	$167.45
Rate for Payer: Cash Price	$128.05
Rate for Payer: Community Health Alliance Commercial	$167.45
Rate for Payer: Priority Health Commercial	$137.90
Rate for Payer: Priority Health PPO	$137.90

KSU-1

Facility

$1.64

Hospital Charge Code	3101512
Hospital Revenue Code	300
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.39
Rate for Payer: Cash Price	$1.07
Rate for Payer: Community Health Alliance Commercial	$1.39
Rate for Payer: Priority Health Commercial	$1.15
Rate for Payer: Priority Health PPO	$1.15

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges