Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

MRSA-LC

Facility

$35.00

Hospital Charge Code	3102432
Hospital Revenue Code	300
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$29.75
Rate for Payer: Cash Price	$22.75
Rate for Payer: Community Health Alliance Commercial	$29.75
Rate for Payer: Priority Health Commercial	$24.50
Rate for Payer: Priority Health PPO	$24.50

MRV BRAIN W/WO (VENBRB)

Facility

$1,607.00

Hospital Charge Code	6100406
Hospital Revenue Code	615
Min. Negotiated Rate	$1,124.90
Max. Negotiated Rate	$1,365.95
Rate for Payer: Cash Price	$1,044.55
Rate for Payer: Community Health Alliance Commercial	$1,365.95
Rate for Payer: Priority Health Commercial	$1,124.90
Rate for Payer: Priority Health PPO	$1,124.90

MSH2 GENE DUP/DELETE VARIANT

Facility

$526.50

Hospital Charge Code	3100932
Hospital Revenue Code	309
Min. Negotiated Rate	$368.55
Max. Negotiated Rate	$447.52
Rate for Payer: Cash Price	$342.23
Rate for Payer: Community Health Alliance Commercial	$447.52
Rate for Payer: Priority Health Commercial	$368.55
Rate for Payer: Priority Health PPO	$368.55

MSH2 GENE FULL SEQ

Facility

$526.50

Hospital Charge Code	3100931
Hospital Revenue Code	309
Min. Negotiated Rate	$368.55
Max. Negotiated Rate	$447.52
Rate for Payer: Cash Price	$342.23
Rate for Payer: Community Health Alliance Commercial	$447.52
Rate for Payer: Priority Health Commercial	$368.55
Rate for Payer: Priority Health PPO	$368.55

MSI-1

Facility

$150.00

Hospital Charge Code	3101343
Hospital Revenue Code	310
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$127.50
Rate for Payer: Cash Price	$97.50
Rate for Payer: Community Health Alliance Commercial	$127.50
Rate for Payer: Priority Health Commercial	$105.00
Rate for Payer: Priority Health PPO	$105.00

MSI-2

Facility

$150.00

Hospital Charge Code	3101344
Hospital Revenue Code	310
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$127.50
Rate for Payer: Cash Price	$97.50
Rate for Payer: Community Health Alliance Commercial	$127.50
Rate for Payer: Priority Health Commercial	$105.00
Rate for Payer: Priority Health PPO	$105.00

MSNP-1

Facility

$41.12

Hospital Charge Code	3102021
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-2

Facility

$41.12

Hospital Charge Code	3102022
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-3

Facility

$41.12

Hospital Charge Code	3102023
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-4

Facility

$41.12

Hospital Charge Code	3102024
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-5

Facility

$41.12

Hospital Charge Code	3102025
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-6

Facility

$41.12

Hospital Charge Code	3102026
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-7

Facility

$41.12

Hospital Charge Code	3102027
Hospital Revenue Code	300
Min. Negotiated Rate	$28.78
Max. Negotiated Rate	$34.95
Rate for Payer: Cash Price	$26.73
Rate for Payer: Community Health Alliance Commercial	$34.95
Rate for Payer: Priority Health Commercial	$28.78
Rate for Payer: Priority Health PPO	$28.78

MSNP-8

Facility

$41.16

Hospital Charge Code	3102028
Hospital Revenue Code	300
Min. Negotiated Rate	$28.81
Max. Negotiated Rate	$34.99
Rate for Payer: Cash Price	$26.75
Rate for Payer: Community Health Alliance Commercial	$34.99
Rate for Payer: Priority Health Commercial	$28.81
Rate for Payer: Priority Health PPO	$28.81

MSP-1

Facility

$12.43

Service Code	HCPCS 83916
Hospital Charge Code	3006300
Hospital Revenue Code	301
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$28.76
Rate for Payer: BCBS BCN 65	$28.76
Rate for Payer: Blue Care Network Medicare Advantage	$28.76
Rate for Payer: Cash Price	$8.08
Rate for Payer: Cash Price	$8.08
Rate for Payer: Community Health Alliance Commercial	$10.57
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$28.76
Rate for Payer: Meridian Health Plan Medicare	$28.76
Rate for Payer: Priority Health Commercial	$8.70
Rate for Payer: Priority Health Medicaid	$28.76
Rate for Payer: Priority Health Medicare	$28.76
Rate for Payer: Priority Health PPO	$8.70
Rate for Payer: United Health Care Medicaid	$28.76
Rate for Payer: United Health Care Medicare Advantage	$12.65

MSP-2

Facility

$12.43

Service Code	HCPCS 83916
Hospital Charge Code	3006310
Hospital Revenue Code	301
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$28.76
Rate for Payer: BCBS BCN 65	$28.76
Rate for Payer: Blue Care Network Medicare Advantage	$28.76
Rate for Payer: Cash Price	$8.08
Rate for Payer: Cash Price	$8.08
Rate for Payer: Community Health Alliance Commercial	$10.57
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$28.76
Rate for Payer: Meridian Health Plan Medicare	$28.76
Rate for Payer: Priority Health Commercial	$8.70
Rate for Payer: Priority Health Medicaid	$28.76
Rate for Payer: Priority Health Medicare	$28.76
Rate for Payer: Priority Health PPO	$8.70
Rate for Payer: United Health Care Medicaid	$28.76
Rate for Payer: United Health Care Medicare Advantage	$12.65

MSP-3

Facility

$12.43

Hospital Charge Code	3102382
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$10.57
Rate for Payer: Cash Price	$8.08
Rate for Payer: Community Health Alliance Commercial	$10.57
Rate for Payer: Priority Health Commercial	$8.70
Rate for Payer: Priority Health PPO	$8.70

MSP-4

Facility

$12.45

Hospital Charge Code	3102383
Hospital Revenue Code	300
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$10.58
Rate for Payer: Cash Price	$8.09
Rate for Payer: Community Health Alliance Commercial	$10.58
Rate for Payer: Priority Health Commercial	$8.71
Rate for Payer: Priority Health PPO	$8.71

MTHFR

Facility

$55.00

Hospital Charge Code	3006197
Hospital Revenue Code	301
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$46.75
Rate for Payer: Cash Price	$35.75
Rate for Payer: Community Health Alliance Commercial	$46.75
Rate for Payer: Priority Health Commercial	$38.50
Rate for Payer: Priority Health PPO	$38.50

MUCICARMINE STAIN TECH

Facility

$70.00

Service Code	HCPCS 88313
Hospital Charge Code	3100390
Hospital Revenue Code	310
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$142.73
Rate for Payer: BCBS BCN 65	$142.73
Rate for Payer: Blue Care Network Medicare Advantage	$142.73
Rate for Payer: Cash Price	$45.50
Rate for Payer: Cash Price	$45.50
Rate for Payer: Community Health Alliance Commercial	$59.50
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	$49.00
Rate for Payer: Priority Health Medicaid	$142.73
Rate for Payer: Priority Health Medicare	$142.73
Rate for Payer: Priority Health PPO	$49.00
Rate for Payer: United Health Care Medicaid	$142.73
Rate for Payer: United Health Care Medicare Advantage	$62.80

MUCIN, SYNOVIAL FLUID

Facility

$31.00

Service Code	HCPCS 83872
Hospital Charge Code	3006200
Hospital Revenue Code	300
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$26.35
Rate for Payer: BCBS BCN 65	$6.15
Rate for Payer: Blue Care Network Medicare Advantage	$6.15
Rate for Payer: Cash Price	$20.15
Rate for Payer: Cash Price	$20.15
Rate for Payer: Community Health Alliance Commercial	$26.35
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$6.15
Rate for Payer: Meridian Health Plan Medicare	$6.15
Rate for Payer: Priority Health Commercial	$21.70
Rate for Payer: Priority Health Medicaid	$6.15
Rate for Payer: Priority Health Medicare	$6.15
Rate for Payer: Priority Health PPO	$21.70
Rate for Payer: United Health Care Medicaid	$6.15
Rate for Payer: United Health Care Medicare Advantage	$2.71

MUCOPOLYSACCHARIDES

Facility

$217.00

Hospital Charge Code	3000277
Hospital Revenue Code	301
Min. Negotiated Rate	$151.90
Max. Negotiated Rate	$184.45
Rate for Payer: Cash Price	$141.05
Rate for Payer: Community Health Alliance Commercial	$184.45
Rate for Payer: Priority Health Commercial	$151.90
Rate for Payer: Priority Health PPO	$151.90

MULTI BAND LIGATOR

Facility

$743.00

Hospital Charge Code	27061923
Hospital Revenue Code	270
Min. Negotiated Rate	$520.10
Max. Negotiated Rate	$631.55
Rate for Payer: Cash Price	$482.95
Rate for Payer: Community Health Alliance Commercial	$631.55
Rate for Payer: Priority Health Commercial	$520.10
Rate for Payer: Priority Health PPO	$520.10

MULTIPLE CLIP APPLIER MCL20

Facility

$252.00

Hospital Charge Code	27014191
Hospital Revenue Code	270
Min. Negotiated Rate	$176.40
Max. Negotiated Rate	$214.20
Rate for Payer: Cash Price	$163.80
Rate for Payer: Community Health Alliance Commercial	$214.20
Rate for Payer: Priority Health Commercial	$176.40
Rate for Payer: Priority Health PPO	$176.40

MUMPS TITER

Facility

$2.44

Service Code	HCPCS 86735
Hospital Charge Code	3006240
Hospital Revenue Code	302
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$13.70
Rate for Payer: BCBS BCN 65	$13.70
Rate for Payer: Blue Care Network Medicare Advantage	$13.70
Rate for Payer: Cash Price	$1.59
Rate for Payer: Cash Price	$1.59
Rate for Payer: Community Health Alliance Commercial	$2.07
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$13.70
Rate for Payer: Meridian Health Plan Medicare	$13.70
Rate for Payer: Priority Health Commercial	$1.71
Rate for Payer: Priority Health Medicaid	$13.70
Rate for Payer: Priority Health Medicare	$13.70
Rate for Payer: Priority Health PPO	$1.71
Rate for Payer: United Health Care Medicaid	$13.70
Rate for Payer: United Health Care Medicare Advantage	$6.03

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges