Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

MUMPS VIRUS PCR

Facility

$200.00

Hospital Charge Code	3101424
Hospital Revenue Code	306
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$170.00
Rate for Payer: Cash Price	$130.00
Rate for Payer: Community Health Alliance Commercial	$170.00
Rate for Payer: Priority Health Commercial	$140.00
Rate for Payer: Priority Health PPO	$140.00

MUSK AB

Facility

$450.00

Service Code	HCPCS 83519
Hospital Charge Code	3000553
Hospital Revenue Code	301
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$382.50
Rate for Payer: BCBS BCN 65	$19.32
Rate for Payer: Blue Care Network Medicare Advantage	$19.32
Rate for Payer: Cash Price	$292.50
Rate for Payer: Cash Price	$292.50
Rate for Payer: Community Health Alliance Commercial	$382.50
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$19.32
Rate for Payer: Meridian Health Plan Medicare	$19.32
Rate for Payer: Priority Health Commercial	$315.00
Rate for Payer: Priority Health Medicaid	$19.32
Rate for Payer: Priority Health Medicare	$19.32
Rate for Payer: Priority Health PPO	$315.00
Rate for Payer: United Health Care Medicaid	$19.32
Rate for Payer: United Health Care Medicare Advantage	$8.50

MUSK ANITBODY

Facility

$360.00

Hospital Charge Code	3101434
Hospital Revenue Code	300
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$306.00
Rate for Payer: Cash Price	$234.00
Rate for Payer: Community Health Alliance Commercial	$306.00
Rate for Payer: Priority Health Commercial	$252.00
Rate for Payer: Priority Health PPO	$252.00

MYAGR-LC1

Facility

$28.88

Hospital Charge Code	3102726
Hospital Revenue Code	300
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$24.55
Rate for Payer: Cash Price	$18.77
Rate for Payer: Community Health Alliance Commercial	$24.55
Rate for Payer: Priority Health Commercial	$20.22
Rate for Payer: Priority Health PPO	$20.22

MYAGR-LC2

Facility

$28.88

Hospital Charge Code	3102727
Hospital Revenue Code	300
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$24.55
Rate for Payer: Cash Price	$18.77
Rate for Payer: Community Health Alliance Commercial	$24.55
Rate for Payer: Priority Health Commercial	$20.22
Rate for Payer: Priority Health PPO	$20.22

MYAGR-LC3

Facility

$28.88

Hospital Charge Code	3102728
Hospital Revenue Code	300
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$24.55
Rate for Payer: Cash Price	$18.77
Rate for Payer: Community Health Alliance Commercial	$24.55
Rate for Payer: Priority Health Commercial	$20.22
Rate for Payer: Priority Health PPO	$20.22

MYAGR-LC4

Facility

$28.91

Hospital Charge Code	3102729
Hospital Revenue Code	300
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$24.57
Rate for Payer: Cash Price	$18.79
Rate for Payer: Community Health Alliance Commercial	$24.57
Rate for Payer: Priority Health Commercial	$20.24
Rate for Payer: Priority Health PPO	$20.24

MYASTHENIA GRAVIS PROFILE

Facility

$115.55

Hospital Charge Code	3102725
Hospital Revenue Code	300
Min. Negotiated Rate	$80.89
Max. Negotiated Rate	$98.22
Rate for Payer: Cash Price	$75.11
Rate for Payer: Community Health Alliance Commercial	$98.22
Rate for Payer: Priority Health Commercial	$80.89
Rate for Payer: Priority Health PPO	$80.89

MYCOBACTERIA A DIR NA PROBE

Facility

$128.00

Hospital Charge Code	3100522
Hospital Revenue Code	306
Min. Negotiated Rate	$89.60
Max. Negotiated Rate	$108.80
Rate for Payer: Cash Price	$83.20
Rate for Payer: Community Health Alliance Commercial	$108.80
Rate for Payer: Priority Health Commercial	$89.60
Rate for Payer: Priority Health PPO	$89.60

MYCOBACTERIA T DIR NA PROBE

Facility

$118.00

Hospital Charge Code	3100523
Hospital Revenue Code	306
Min. Negotiated Rate	$82.60
Max. Negotiated Rate	$100.30
Rate for Payer: Cash Price	$76.70
Rate for Payer: Community Health Alliance Commercial	$100.30
Rate for Payer: Priority Health Commercial	$82.60
Rate for Payer: Priority Health PPO	$82.60

MYCOPLASMA AMPLIF NA PROBE

Facility

$187.34

Hospital Charge Code	3100115
Hospital Revenue Code	300
Min. Negotiated Rate	$131.14
Max. Negotiated Rate	$159.24
Rate for Payer: Cash Price	$121.77
Rate for Payer: Community Health Alliance Commercial	$159.24
Rate for Payer: Priority Health Commercial	$131.14
Rate for Payer: Priority Health PPO	$131.14

MYCOPLASMA PCR

Facility

$73.75

Hospital Charge Code	3101008
Hospital Revenue Code	306
Min. Negotiated Rate	$51.62
Max. Negotiated Rate	$62.69
Rate for Payer: Cash Price	$47.94
Rate for Payer: Community Health Alliance Commercial	$62.69
Rate for Payer: Priority Health Commercial	$51.62
Rate for Payer: Priority Health PPO	$51.62

MYCOPLASMA PNEUMONIAE TITE RML

Facility

$5.70

Service Code	HCPCS 86738
Hospital Charge Code	3006260
Hospital Revenue Code	302
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$13.90
Rate for Payer: BCBS BCN 65	$13.90
Rate for Payer: Blue Care Network Medicare Advantage	$13.90
Rate for Payer: Cash Price	$3.71
Rate for Payer: Cash Price	$3.71
Rate for Payer: Community Health Alliance Commercial	$4.84
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$13.90
Rate for Payer: Meridian Health Plan Medicare	$13.90
Rate for Payer: Priority Health Commercial	$3.99
Rate for Payer: Priority Health Medicaid	$13.90
Rate for Payer: Priority Health Medicare	$13.90
Rate for Payer: Priority Health PPO	$3.99
Rate for Payer: United Health Care Medicaid	$13.90
Rate for Payer: United Health Care Medicare Advantage	$6.12

MYCOPLASMA TO STATE

Facility

$41.00

Service Code	HCPCS 86738
Hospital Charge Code	3006220
Hospital Revenue Code	302
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$34.85
Rate for Payer: BCBS BCN 65	$13.90
Rate for Payer: Blue Care Network Medicare Advantage	$13.90
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	$13.90
Rate for Payer: Meridian Health Plan Medicare	$13.90
Rate for Payer: Priority Health Commercial	$28.70
Rate for Payer: Priority Health Medicaid	$13.90
Rate for Payer: Priority Health Medicare	$13.90
Rate for Payer: Priority Health PPO	$28.70
Rate for Payer: United Health Care Medicaid	$13.90
Rate for Payer: United Health Care Medicare Advantage	$6.12

MYCO TB BY PCR

Facility

$318.00

Hospital Charge Code	3008590
Hospital Revenue Code	306
Min. Negotiated Rate	$222.60
Max. Negotiated Rate	$270.30
Rate for Payer: Cash Price	$206.70
Rate for Payer: Community Health Alliance Commercial	$270.30
Rate for Payer: Priority Health Commercial	$222.60
Rate for Payer: Priority Health PPO	$222.60

MYCROPHENOLIC ACID

Facility

$40.00

Hospital Charge Code	3007162
Hospital Revenue Code	301
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$34.00
Rate for Payer: Cash Price	$26.00
Rate for Payer: Community Health Alliance Commercial	$34.00
Rate for Payer: Priority Health Commercial	$28.00
Rate for Payer: Priority Health PPO	$28.00

MYEL-2

Facility

$16.25

Hospital Charge Code	3102126
Hospital Revenue Code	300
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$13.81
Rate for Payer: Cash Price	$10.56
Rate for Payer: Community Health Alliance Commercial	$13.81
Rate for Payer: Priority Health Commercial	$11.38
Rate for Payer: Priority Health PPO	$11.38

MYEL-3

Facility

$16.26

Hospital Charge Code	3102127
Hospital Revenue Code	300
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$13.82
Rate for Payer: Cash Price	$10.57
Rate for Payer: Community Health Alliance Commercial	$13.82
Rate for Payer: Priority Health Commercial	$11.38
Rate for Payer: Priority Health PPO	$11.38

MYELIN ANTIBODIES IgA

Facility

$81.00

Service Code	HCPCS 83520
Hospital Charge Code	3005206
Hospital Revenue Code	301
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$68.85
Rate for Payer: BCBS BCN 65	$18.13
Rate for Payer: Blue Care Network Medicare Advantage	$18.13
Rate for Payer: Cash Price	$52.65
Rate for Payer: Cash Price	$52.65
Rate for Payer: Community Health Alliance Commercial	$68.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.13
Rate for Payer: Meridian Health Plan Medicare	$18.13
Rate for Payer: Priority Health Commercial	$56.70
Rate for Payer: Priority Health Medicaid	$18.13
Rate for Payer: Priority Health Medicare	$18.13
Rate for Payer: Priority Health PPO	$56.70
Rate for Payer: United Health Care Medicaid	$18.13
Rate for Payer: United Health Care Medicare Advantage	$7.98

MYELIN ANTIBODIES IgG

Facility

$81.00

Service Code	HCPCS 83520
Hospital Charge Code	3005207
Hospital Revenue Code	301
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$68.85
Rate for Payer: BCBS BCN 65	$18.13
Rate for Payer: Blue Care Network Medicare Advantage	$18.13
Rate for Payer: Cash Price	$52.65
Rate for Payer: Cash Price	$52.65
Rate for Payer: Community Health Alliance Commercial	$68.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.13
Rate for Payer: Meridian Health Plan Medicare	$18.13
Rate for Payer: Priority Health Commercial	$56.70
Rate for Payer: Priority Health Medicaid	$18.13
Rate for Payer: Priority Health Medicare	$18.13
Rate for Payer: Priority Health PPO	$56.70
Rate for Payer: United Health Care Medicaid	$18.13
Rate for Payer: United Health Care Medicare Advantage	$7.98

MYELIN ANTIBODIES IgM

Facility

$81.00

Service Code	HCPCS 83520
Hospital Charge Code	3005208
Hospital Revenue Code	301
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$68.85
Rate for Payer: BCBS BCN 65	$18.13
Rate for Payer: Blue Care Network Medicare Advantage	$18.13
Rate for Payer: Cash Price	$52.65
Rate for Payer: Cash Price	$52.65
Rate for Payer: Community Health Alliance Commercial	$68.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.13
Rate for Payer: Meridian Health Plan Medicare	$18.13
Rate for Payer: Priority Health Commercial	$56.70
Rate for Payer: Priority Health Medicaid	$18.13
Rate for Payer: Priority Health Medicare	$18.13
Rate for Payer: Priority Health PPO	$56.70
Rate for Payer: United Health Care Medicaid	$18.13
Rate for Payer: United Health Care Medicare Advantage	$7.98

MYELIN BASIC PROTEIN CSF

Facility

$13.16

Service Code	HCPCS 83873
Hospital Charge Code	3005220
Hospital Revenue Code	301
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$18.06
Rate for Payer: BCBS BCN 65	$18.06
Rate for Payer: Blue Care Network Medicare Advantage	$18.06
Rate for Payer: Cash Price	$8.55
Rate for Payer: Cash Price	$8.55
Rate for Payer: Community Health Alliance Commercial	$11.19
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.06
Rate for Payer: Meridian Health Plan Medicare	$18.06
Rate for Payer: Priority Health Commercial	$9.21
Rate for Payer: Priority Health Medicaid	$18.06
Rate for Payer: Priority Health Medicare	$18.06
Rate for Payer: Priority Health PPO	$9.21
Rate for Payer: United Health Care Medicaid	$18.06
Rate for Payer: United Health Care Medicare Advantage	$7.95

MYELIN OLIGODENDROCYTE GLYCO

Facility

$200.00

Hospital Charge Code	3101442
Hospital Revenue Code	300
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$170.00
Rate for Payer: Cash Price	$130.00
Rate for Payer: Community Health Alliance Commercial	$170.00
Rate for Payer: Priority Health Commercial	$140.00
Rate for Payer: Priority Health PPO	$140.00

MYELOGRAM 2 OR MORE REGIONS

Facility

$1,726.00

Hospital Charge Code	3201065
Hospital Revenue Code	320
Min. Negotiated Rate	$1,208.20
Max. Negotiated Rate	$1,467.10
Rate for Payer: Cash Price	$1,121.90
Rate for Payer: Community Health Alliance Commercial	$1,467.10
Rate for Payer: Priority Health Commercial	$1,208.20
Rate for Payer: Priority Health PPO	$1,208.20

MYELOPEROXIDASE IgG ANTIBODY

Facility

$56.00

Hospital Charge Code	3100029
Hospital Revenue Code	301
Min. Negotiated Rate	$39.20
Max. Negotiated Rate	$47.60
Rate for Payer: Cash Price	$36.40
Rate for Payer: Community Health Alliance Commercial	$47.60
Rate for Payer: Priority Health Commercial	$39.20
Rate for Payer: Priority Health PPO	$39.20

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges