Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

RAST STACHYBOTRYS CHARTARUM

Facility

$16.45

Hospital Charge Code	3100718
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$13.98
Rate for Payer: Cash Price	$10.69
Rate for Payer: Community Health Alliance Commercial	$13.98
Rate for Payer: Priority Health Commercial	$11.52
Rate for Payer: Priority Health PPO	$11.52

RAST-STRAWBERRY

Facility

$15.00

Hospital Charge Code	3006239
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-SUNFLOWER SEED

Facility

$3.26

Hospital Charge Code	3101842
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 SYCAMORE TREE

Facility

$10.10

Hospital Charge Code	3100745
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-TIMOTHY GRASS

Facility

$3.26

Hospital Charge Code	3006209
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 TOBACCO

Facility

$10.10

Hospital Charge Code	3100610
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 TOMATO

Facility

$10.10

Hospital Charge Code	3006659
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-TREE

Facility

$24.00

Service Code	HCPCS 86005
Hospital Charge Code	3006536
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 TROUT

Facility

$10.10

Hospital Charge Code	3101073
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 TUNA

Facility

$3.26

Hospital Charge Code	3100352
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 TURKEY FEATHERS

Facility

$15.00

Hospital Charge Code	3100604
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-VEG

Facility

$24.00

Hospital Charge Code	3006610
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 VERNAL GRASS

Facility

$10.10

Hospital Charge Code	3006282
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 WALIBUT-LC

Facility

$3.26

Hospital Charge Code	3102716
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 WALLEYE PIKE-LC

Facility

$3.26

Hospital Charge Code	3102714
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 WALNUT

Facility

$12.00

Hospital Charge Code	3101397
Hospital Revenue Code	300
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-WALNUT

Facility

$3.26

Hospital Charge Code	3006551
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 WALNUT POLLEN

Facility

$3.26

Hospital Charge Code	3102138
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-WATERMELON

Facility

$15.00

Hospital Charge Code	3006296
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-WEED

Facility

$24.00

Service Code	HCPCS 86005
Hospital Charge Code	3006537
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-WHEAT

Facility

$3.26

Hospital Charge Code	3006544
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 WHEY

Facility

$10.10

Hospital Charge Code	3100112
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 WHITEASH

Facility

$3.26

Hospital Charge Code	3006206
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 WHITE FACE HORNET

Facility

$15.00

Hospital Charge Code	3101003
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 WHITE PINE

Facility

$3.26

Hospital Charge Code	3101501
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

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges