Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

NEEDLE,DURASPHERE 18 GA X 15"

Facility

$66.00

Hospital Charge Code	27268050
Hospital Revenue Code	272
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$56.10
Rate for Payer: Cash Price	$42.90
Rate for Payer: Community Health Alliance Commercial	$56.10
Rate for Payer: Priority Health Commercial	$46.20
Rate for Payer: Priority Health PPO	$46.20

NEEDLE EZ-IO PD NEEDLE SET

Facility

$334.67

Hospital Charge Code	27275082
Hospital Revenue Code	272
Min. Negotiated Rate	$234.27
Max. Negotiated Rate	$284.47
Rate for Payer: Cash Price	$217.54
Rate for Payer: Community Health Alliance Commercial	$284.47
Rate for Payer: Priority Health Commercial	$234.27
Rate for Payer: Priority Health PPO	$234.27

NEEDLE, HOWELL BILIARY ASP

Facility

$268.00

Hospital Charge Code	27262036
Hospital Revenue Code	272
Min. Negotiated Rate	$187.60
Max. Negotiated Rate	$227.80
Rate for Payer: Cash Price	$174.20
Rate for Payer: Community Health Alliance Commercial	$227.80
Rate for Payer: Priority Health Commercial	$187.60
Rate for Payer: Priority Health PPO	$187.60

NEEDLE, ILL STERNAL/ILLAC ASP

Facility

$65.00

Hospital Charge Code	27261790
Hospital Revenue Code	272
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$55.25
Rate for Payer: Cash Price	$42.25
Rate for Payer: Community Health Alliance Commercial	$55.25
Rate for Payer: Priority Health Commercial	$45.50
Rate for Payer: Priority Health PPO	$45.50

NEEDLE, JAMSHIDI 11GA X 4"

Facility

$81.00

Hospital Charge Code	27261432
Hospital Revenue Code	272
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$68.85
Rate for Payer: Cash Price	$52.65
Rate for Payer: Community Health Alliance Commercial	$68.85
Rate for Payer: Priority Health Commercial	$56.70
Rate for Payer: Priority Health PPO	$56.70

NEEDLE LOCALIZATION

Facility

$132.00

Hospital Charge Code	5150751
Hospital Revenue Code	960
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$112.20
Rate for Payer: Cash Price	$85.80
Rate for Payer: Community Health Alliance Commercial	$112.20
Rate for Payer: Priority Health Commercial	$92.40
Rate for Payer: Priority Health PPO	$92.40

NEEDLE LOCALIZ. BREAST

Facility

$164.00

Service Code	HCPCS 19290
Hospital Charge Code	3201374
Hospital Revenue Code	361
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

NEEDLE,PERCUTANEOUS ENTRY

Facility

$21.00

Hospital Charge Code	27060701
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$17.85
Rate for Payer: Cash Price	$13.65
Rate for Payer: Community Health Alliance Commercial	$17.85
Rate for Payer: Priority Health Commercial	$14.70
Rate for Payer: Priority Health PPO	$14.70

NEEDLE,ULTRA VERESS

Facility

$97.00

Hospital Charge Code	27019406
Hospital Revenue Code	270
Min. Negotiated Rate	$67.90
Max. Negotiated Rate	$82.45
Rate for Payer: Cash Price	$63.05
Rate for Payer: Community Health Alliance Commercial	$82.45
Rate for Payer: Priority Health Commercial	$67.90
Rate for Payer: Priority Health PPO	$67.90

NEG PRS WND THER NDME>50SQCM

Facility

$59.00

Hospital Charge Code	5150796
Hospital Revenue Code	960
Min. Negotiated Rate	$41.30
Max. Negotiated Rate	$50.15
Rate for Payer: Cash Price	$38.35
Rate for Payer: Community Health Alliance Commercial	$50.15
Rate for Payer: Priority Health Commercial	$41.30
Rate for Payer: Priority Health PPO	$41.30

NEOPLASTIC BONE MARROW

Facility

$363.00

Hospital Charge Code	3005493
Hospital Revenue Code	311
Min. Negotiated Rate	$254.10
Max. Negotiated Rate	$308.55
Rate for Payer: Cash Price	$235.95
Rate for Payer: Community Health Alliance Commercial	$308.55
Rate for Payer: Priority Health Commercial	$254.10
Rate for Payer: Priority Health PPO	$254.10

NEPHELOMETRY

Facility

$61.00

Hospital Charge Code	3009890
Hospital Revenue Code	301
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$51.85
Rate for Payer: Cash Price	$39.65
Rate for Payer: Community Health Alliance Commercial	$51.85
Rate for Payer: Priority Health Commercial	$42.70
Rate for Payer: Priority Health PPO	$42.70

NEPHELOMETRY

Facility

$61.00

Hospital Charge Code	3009889
Hospital Revenue Code	301
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$51.85
Rate for Payer: Cash Price	$39.65
Rate for Payer: Community Health Alliance Commercial	$51.85
Rate for Payer: Priority Health Commercial	$42.70
Rate for Payer: Priority Health PPO	$42.70

NEPHELOMETRY

Facility

$14.00

Hospital Charge Code	3009888
Hospital Revenue Code	301
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

NEPHELOMETRY

Facility

$14.00

Hospital Charge Code	3009887
Hospital Revenue Code	301
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

NERVE STIMULATOR LOCATOR

Facility

$296.00

Hospital Charge Code	27265478
Hospital Revenue Code	272
Min. Negotiated Rate	$207.20
Max. Negotiated Rate	$251.60
Rate for Payer: Cash Price	$192.40
Rate for Payer: Community Health Alliance Commercial	$251.60
Rate for Payer: Priority Health Commercial	$207.20
Rate for Payer: Priority Health PPO	$207.20

NEUROMUSCULAR RE-ED 15 MINUTES

Facility

$86.00

Service Code	HCPCS 97112 GP
Hospital Charge Code	4200250
Hospital Revenue Code	420
Min. Negotiated Rate	$60.20
Max. Negotiated Rate	$73.10
Rate for Payer: Cash Price	$55.90
Rate for Payer: Community Health Alliance Commercial	$73.10
Rate for Payer: Priority Health Commercial	$60.20
Rate for Payer: Priority Health PPO	$60.20

NEUROMUSCULAR RE-ED EA 15 MIN

Facility

$86.00

Hospital Charge Code	4300065
Hospital Revenue Code	430
Min. Negotiated Rate	$60.20
Max. Negotiated Rate	$73.10
Rate for Payer: Cash Price	$55.90
Rate for Payer: Community Health Alliance Commercial	$73.10
Rate for Payer: Priority Health Commercial	$60.20
Rate for Payer: Priority Health PPO	$60.20

NEUROMYELITIS OPTICA AB

Facility

$266.00

Hospital Charge Code	3100740
Hospital Revenue Code	300
Min. Negotiated Rate	$186.20
Max. Negotiated Rate	$226.10
Rate for Payer: Cash Price	$172.90
Rate for Payer: Community Health Alliance Commercial	$226.10
Rate for Payer: Priority Health Commercial	$186.20
Rate for Payer: Priority Health PPO	$186.20

NEURONTIN

Facility

$8.15

Service Code	HCPCS 80299
Hospital Charge Code	3003700
Hospital Revenue Code	301
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$19.57
Rate for Payer: BCBS BCN 65	$19.57
Rate for Payer: Blue Care Network Medicare Advantage	$19.57
Rate for Payer: Cash Price	$5.30
Rate for Payer: Cash Price	$5.30
Rate for Payer: Community Health Alliance Commercial	$6.93
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$19.57
Rate for Payer: Meridian Health Plan Medicare	$19.57
Rate for Payer: Priority Health Commercial	$5.71
Rate for Payer: Priority Health Medicaid	$19.57
Rate for Payer: Priority Health Medicare	$19.57
Rate for Payer: Priority Health PPO	$5.71
Rate for Payer: United Health Care Medicaid	$19.57
Rate for Payer: United Health Care Medicare Advantage	$8.61

NEUTROPHIL ANTIBODY LEVEL 1

Facility

$159.00

Hospital Charge Code	3000146
Hospital Revenue Code	302
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$135.15
Rate for Payer: Cash Price	$103.35
Rate for Payer: Community Health Alliance Commercial	$135.15
Rate for Payer: Priority Health Commercial	$111.30
Rate for Payer: Priority Health PPO	$111.30

NEUTROPHIL ANTIBODY LEVEL 2

Facility

$161.00

Hospital Charge Code	3000150
Hospital Revenue Code	302
Min. Negotiated Rate	$112.70
Max. Negotiated Rate	$136.85
Rate for Payer: Cash Price	$104.65
Rate for Payer: Community Health Alliance Commercial	$136.85
Rate for Payer: Priority Health Commercial	$112.70
Rate for Payer: Priority Health PPO	$112.70

NEUTROPHIL CYSTOPLASMIC IgG

Facility

$77.00

Hospital Charge Code	3100027
Hospital Revenue Code	302
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$65.45
Rate for Payer: Cash Price	$50.05
Rate for Payer: Community Health Alliance Commercial	$65.45
Rate for Payer: Priority Health Commercial	$53.90
Rate for Payer: Priority Health PPO	$53.90

NEUTROPHIL OXIDATIVE BURST

Facility

$170.35

Hospital Charge Code	3102398
Hospital Revenue Code	300
Min. Negotiated Rate	$119.25
Max. Negotiated Rate	$144.80
Rate for Payer: Cash Price	$110.73
Rate for Payer: Community Health Alliance Commercial	$144.80
Rate for Payer: Priority Health Commercial	$119.25
Rate for Payer: Priority Health PPO	$119.25

NEW PATIENT BRIEF

Facility

$196.00

Service Code	HCPCS G0463
Hospital Charge Code	5150656
Hospital Revenue Code	510
Min. Negotiated Rate	$62.84
Max. Negotiated Rate	$166.60
Rate for Payer: BCBS BCN 65	$142.82
Rate for Payer: Blue Care Network Medicare Advantage	$142.82
Rate for Payer: Cash Price	$127.40
Rate for Payer: Cash Price	$127.40
Rate for Payer: Community Health Alliance Commercial	$166.60
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$142.82
Rate for Payer: Meridian Health Plan Medicare	$142.82
Rate for Payer: Priority Health Commercial	$137.20
Rate for Payer: Priority Health Medicaid	$142.82
Rate for Payer: Priority Health Medicare	$142.82
Rate for Payer: Priority Health PPO	$137.20
Rate for Payer: United Health Care Medicaid	$142.82
Rate for Payer: United Health Care Medicare Advantage	$62.84

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges