Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

RAST DERMATOPHAGOIDES FARINA

Facility

$3.26

Hospital Charge Code	3006237
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST DERMATOPHAGOIDES PTERONY

Facility

$3.26

Hospital Charge Code	3006238
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST DOG DANDER

Facility

$3.26

Hospital Charge Code	3006236
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST DOG EPITHELIUM

Facility

$15.00

Hospital Charge Code	3006667
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

RAST DUCK FEATHERS

Facility

$15.00

Hospital Charge Code	3100705
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

RAST-DUST

Facility

$19.70

Service Code	HCPCS 86005
Hospital Charge Code	3006531
Hospital Revenue Code	302
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$16.75
Rate for Payer: BCBS BCN 65	$8.37
Rate for Payer: Blue Care Network Medicare Advantage	$8.37
Rate for Payer: Cash Price	$12.81
Rate for Payer: Cash Price	$12.81
Rate for Payer: Community Health Alliance Commercial	$16.75
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.37
Rate for Payer: Meridian Health Plan Medicare	$8.37
Rate for Payer: Priority Health Commercial	$13.79
Rate for Payer: Priority Health Medicaid	$8.37
Rate for Payer: Priority Health Medicare	$8.37
Rate for Payer: Priority Health PPO	$13.79
Rate for Payer: United Health Care Medicaid	$8.37
Rate for Payer: United Health Care Medicare Advantage	$3.68

RAST-EGGWHITE

Facility

$3.26

Hospital Charge Code	3006541
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST EGG YOLK

Facility

$15.00

Hospital Charge Code	3100111
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

RAST ELM

Facility

$3.26

Hospital Charge Code	3100121
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST ENGLISH PLANTAIN

Facility

$3.26

Hospital Charge Code	3006668
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST ENGLISH WALNUT

Facility

$12.00

Hospital Charge Code	3100253
Hospital Revenue Code	302
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$10.20
Rate for Payer: Cash Price	$7.80
Rate for Payer: Community Health Alliance Commercial	$10.20
Rate for Payer: Priority Health Commercial	$8.40
Rate for Payer: Priority Health PPO	$8.40

RAST EPICCUM NIGRUM

Facility

$3.26

Hospital Charge Code	3101494
Hospital Revenue Code	300
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST-FEATHERS

Facility

$24.00

Hospital Charge Code	3006617
Hospital Revenue Code	302
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$20.40
Rate for Payer: Cash Price	$15.60
Rate for Payer: Community Health Alliance Commercial	$20.40
Rate for Payer: Priority Health Commercial	$16.80
Rate for Payer: Priority Health PPO	$16.80

RAST-FOOD

Facility

$24.00

Service Code	HCPCS 86005
Hospital Charge Code	3006532
Hospital Revenue Code	302
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$20.40
Rate for Payer: BCBS BCN 65	$8.37
Rate for Payer: Blue Care Network Medicare Advantage	$8.37
Rate for Payer: Cash Price	$15.60
Rate for Payer: Cash Price	$15.60
Rate for Payer: Community Health Alliance Commercial	$20.40
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.37
Rate for Payer: Meridian Health Plan Medicare	$8.37
Rate for Payer: Priority Health Commercial	$16.80
Rate for Payer: Priority Health Medicaid	$8.37
Rate for Payer: Priority Health Medicare	$8.37
Rate for Payer: Priority Health PPO	$16.80
Rate for Payer: United Health Care Medicaid	$8.37
Rate for Payer: United Health Care Medicare Advantage	$3.68

RAST-FRUITS #2

Facility

$24.00

Hospital Charge Code	3006615
Hospital Revenue Code	302
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$20.40
Rate for Payer: Cash Price	$15.60
Rate for Payer: Community Health Alliance Commercial	$20.40
Rate for Payer: Priority Health Commercial	$16.80
Rate for Payer: Priority Health PPO	$16.80

RAST FUSARIUM VASINEFECTUM

Facility

$29.45

Hospital Charge Code	3101496
Hospital Revenue Code	300
Min. Negotiated Rate	$20.61
Max. Negotiated Rate	$25.03
Rate for Payer: Cash Price	$19.14
Rate for Payer: Community Health Alliance Commercial	$25.03
Rate for Payer: Priority Health Commercial	$20.61
Rate for Payer: Priority Health PPO	$20.61

RAST-GARLIC

Facility

$10.10

Hospital Charge Code	3101115
Hospital Revenue Code	302
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$8.59
Rate for Payer: Cash Price	$6.57
Rate for Payer: Community Health Alliance Commercial	$8.59
Rate for Payer: Priority Health Commercial	$7.07
Rate for Payer: Priority Health PPO	$7.07

RAST GIANT RAGWEED

Facility

$3.26

Hospital Charge Code	3101515
Hospital Revenue Code	300
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST GLUTEN

Facility

$3.26

Hospital Charge Code	3100103
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.77
Rate for Payer: Cash Price	$2.12
Rate for Payer: Community Health Alliance Commercial	$2.77
Rate for Payer: Priority Health Commercial	$2.28
Rate for Payer: Priority Health PPO	$2.28

RAST GOAP EPI

Facility

$10.10

Hospital Charge Code	3100600
Hospital Revenue Code	302
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$8.59
Rate for Payer: Cash Price	$6.57
Rate for Payer: Community Health Alliance Commercial	$8.59
Rate for Payer: Priority Health Commercial	$7.07
Rate for Payer: Priority Health PPO	$7.07

RAST GOATS MILK IGE

Facility

$10.10

Hospital Charge Code	3100515
Hospital Revenue Code	302
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$8.59
Rate for Payer: Cash Price	$6.57
Rate for Payer: Community Health Alliance Commercial	$8.59
Rate for Payer: Priority Health Commercial	$7.07
Rate for Payer: Priority Health PPO	$7.07

RAST GOOSE FEATHERS

Facility

$15.00

Hospital Charge Code	3100707
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

RAST-GRAINS

Facility

$19.70

Hospital Charge Code	3006614
Hospital Revenue Code	302
Min. Negotiated Rate	$13.79
Max. Negotiated Rate	$16.75
Rate for Payer: Cash Price	$12.81
Rate for Payer: Community Health Alliance Commercial	$16.75
Rate for Payer: Priority Health Commercial	$13.79
Rate for Payer: Priority Health PPO	$13.79

RAST-GRAPE

Facility

$10.10

Hospital Charge Code	3006242
Hospital Revenue Code	302
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$8.59
Rate for Payer: Cash Price	$6.57
Rate for Payer: Community Health Alliance Commercial	$8.59
Rate for Payer: Priority Health Commercial	$7.07
Rate for Payer: Priority Health PPO	$7.07

RAST GRAPEFRUIT

Facility

$15.00

Hospital Charge Code	3100085
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges