Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

604726-3

Facility

$9.00

Hospital Charge Code	31027689
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

604726-4

Facility

$9.00

Hospital Charge Code	31027690
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

6 MINUTE WALK

Facility

$268.00

Hospital Charge Code	4100036
Hospital Revenue Code	410
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

7-DEHYDROCHOLESTEROL

Facility

$175.00

Hospital Charge Code	3101305
Hospital Revenue Code	301
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$148.75
Rate for Payer: Cash Price	$113.75
Rate for Payer: Community Health Alliance Commercial	$148.75
Rate for Payer: Priority Health Commercial	$122.50
Rate for Payer: Priority Health PPO	$122.50

88305 SurgPath 1st

Facility

$28.47

Service Code	HCPCS 88305
Hospital Charge Code	31027477
Hospital Revenue Code	300
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$55.90
Rate for Payer: BCBS BCN 65	$55.90
Rate for Payer: Blue Care Network Medicare Advantage	$55.90
Rate for Payer: Cash Price	$18.51
Rate for Payer: Cash Price	$18.51
Rate for Payer: Community Health Alliance Commercial	$24.20
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$55.90
Rate for Payer: Meridian Health Plan Medicare	$55.90
Rate for Payer: Priority Health Commercial	$19.93
Rate for Payer: Priority Health Medicaid	$55.90
Rate for Payer: Priority Health Medicare	$55.90
Rate for Payer: Priority Health PPO	$19.93
Rate for Payer: United Health Care Medicaid	$55.90
Rate for Payer: United Health Care Medicare Advantage	$24.60

88305 SurgPath 2nd

Facility

$28.47

Hospital Charge Code	31027478
Hospital Revenue Code	300
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$24.20
Rate for Payer: Cash Price	$18.51
Rate for Payer: Community Health Alliance Commercial	$24.20
Rate for Payer: Priority Health Commercial	$19.93
Rate for Payer: Priority Health PPO	$19.93

A15-1

Facility

$25.46

Hospital Charge Code	31027660
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-10

Facility

$25.46

Hospital Charge Code	31027669
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-11

Facility

$25.46

Hospital Charge Code	31027670
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-12

Facility

$25.46

Hospital Charge Code	31027671
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-13

Facility

$25.46

Hospital Charge Code	31027672
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-14

Facility

$25.46

Hospital Charge Code	31027673
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-15

Facility

$25.46

Hospital Charge Code	31027674
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-2

Facility

$25.46

Hospital Charge Code	31027661
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-3

Facility

$25.46

Hospital Charge Code	31027662
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-4

Facility

$25.46

Hospital Charge Code	31027663
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-5

Facility

$25.46

Hospital Charge Code	31027664
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-6

Facility

$25.46

Hospital Charge Code	31027665
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-7

Facility

$25.46

Hospital Charge Code	31027666
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-8

Facility

$25.46

Hospital Charge Code	31027667
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

A15-9

Facility

$25.46

Hospital Charge Code	31027668
Hospital Revenue Code	300
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$21.64
Rate for Payer: Cash Price	$16.55
Rate for Payer: Community Health Alliance Commercial	$21.64
Rate for Payer: Priority Health Commercial	$17.82
Rate for Payer: Priority Health PPO	$17.82

AAS-1

Facility

$20.00

Hospital Charge Code	3102522
Hospital Revenue Code	300
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$17.00
Rate for Payer: Cash Price	$13.00
Rate for Payer: Community Health Alliance Commercial	$17.00
Rate for Payer: Priority Health Commercial	$14.00
Rate for Payer: Priority Health PPO	$14.00

AAS-2

Facility

$20.00

Hospital Charge Code	3102523
Hospital Revenue Code	300
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$17.00
Rate for Payer: Cash Price	$13.00
Rate for Payer: Community Health Alliance Commercial	$17.00
Rate for Payer: Priority Health Commercial	$14.00
Rate for Payer: Priority Health PPO	$14.00

AB0-IBC

Facility

$19.50

Hospital Charge Code	3101933
Hospital Revenue Code	300
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$16.57
Rate for Payer: Cash Price	$12.68
Rate for Payer: Community Health Alliance Commercial	$16.57
Rate for Payer: Priority Health Commercial	$13.65
Rate for Payer: Priority Health PPO	$13.65

ABCD-1 GENE ANALYSIS ARUP

Facility

$1,015.00

Hospital Charge Code	3101925
Hospital Revenue Code	300
Min. Negotiated Rate	$710.50
Max. Negotiated Rate	$862.75
Rate for Payer: Cash Price	$659.75
Rate for Payer: Community Health Alliance Commercial	$862.75
Rate for Payer: Priority Health Commercial	$710.50
Rate for Payer: Priority Health PPO	$710.50

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges