Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

RAST WILLOW TREE

Facility

$3.26

Hospital Charge Code	3102142
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 YELLOW HORNET

Facility

$15.00

Hospital Charge Code	3101004
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 YELLOW JACKET

Facility

$15.00

Hospital Charge Code	3006664
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

RAT CAT DANDER & EPITHELIUM

Facility

$3.26

Hospital Charge Code	3006666
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

RA TEST QUANT

Facility

$34.00

Service Code	HCPCS 86431
Hospital Charge Code	3006520
Hospital Revenue Code	302
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$28.90
Rate for Payer: BCBS BCN 65	$5.95
Rate for Payer: Blue Care Network Medicare Advantage	$5.95
Rate for Payer: Cash Price	$22.10
Rate for Payer: Cash Price	$22.10
Rate for Payer: Community Health Alliance Commercial	$28.90
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$5.95
Rate for Payer: Meridian Health Plan Medicare	$5.95
Rate for Payer: Priority Health Commercial	$23.80
Rate for Payer: Priority Health Medicaid	$5.95
Rate for Payer: Priority Health Medicare	$5.95
Rate for Payer: Priority Health PPO	$23.80
Rate for Payer: United Health Care Medicaid	$5.95
Rate for Payer: United Health Care Medicare Advantage	$2.62

RBC AB ELUTION EA-R

Facility

$82.00

Hospital Charge Code	3100083
Hospital Revenue Code	300
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$69.70
Rate for Payer: Cash Price	$53.30
Rate for Payer: Community Health Alliance Commercial	$69.70
Rate for Payer: Priority Health Commercial	$57.40
Rate for Payer: Priority Health PPO	$57.40

RBC AB SCRN EA TECHIQ-R

Facility

$46.00

Hospital Charge Code	3100074
Hospital Revenue Code	300
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$39.10
Rate for Payer: Cash Price	$29.90
Rate for Payer: Community Health Alliance Commercial	$39.10
Rate for Payer: Priority Health Commercial	$32.20
Rate for Payer: Priority Health PPO	$32.20

RBC AG FWRBC

Facility

$41.00

Hospital Charge Code	3101420
Hospital Revenue Code	300
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$34.85
Rate for Payer: Cash Price	$26.65
Rate for Payer: Community Health Alliance Commercial	$34.85
Rate for Payer: Priority Health Commercial	$28.70
Rate for Payer: Priority Health PPO	$28.70

RBC ANTIGEN PHENOTYPE MOLECULA

Facility

$464.00

Hospital Charge Code	3100772
Hospital Revenue Code	310
Min. Negotiated Rate	$324.80
Max. Negotiated Rate	$394.40
Rate for Payer: Cash Price	$301.60
Rate for Payer: Community Health Alliance Commercial	$394.40
Rate for Payer: Priority Health Commercial	$324.80
Rate for Payer: Priority Health PPO	$324.80

RBC LEUKOCYTE REDUCED - 1 UNIT

Facility

$565.00

Service Code	HCPCS P9016
Hospital Charge Code	3910050
Hospital Revenue Code	390
Min. Negotiated Rate	$85.43
Max. Negotiated Rate	$480.25
Rate for Payer: BCBS BCN 65	$194.16
Rate for Payer: Blue Care Network Medicare Advantage	$194.16
Rate for Payer: Cash Price	$367.25
Rate for Payer: Cash Price	$367.25
Rate for Payer: Community Health Alliance Commercial	$480.25
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$194.16
Rate for Payer: Meridian Health Plan Medicare	$194.16
Rate for Payer: Priority Health Commercial	$395.50
Rate for Payer: Priority Health Medicaid	$194.16
Rate for Payer: Priority Health Medicare	$194.16
Rate for Payer: Priority Health PPO	$395.50
Rate for Payer: United Health Care Medicaid	$194.16
Rate for Payer: United Health Care Medicare Advantage	$85.43

REAMER METATARSAL

Facility

$1,102.50

Hospital Charge Code	27283839
Hospital Revenue Code	272
Min. Negotiated Rate	$771.75
Max. Negotiated Rate	$937.12
Rate for Payer: Cash Price	$716.63
Rate for Payer: Community Health Alliance Commercial	$937.12
Rate for Payer: Priority Health Commercial	$771.75
Rate for Payer: Priority Health PPO	$771.75

REAMER PHALANGEAL

Facility

$1,102.50

Hospital Charge Code	27283903
Hospital Revenue Code	272
Min. Negotiated Rate	$771.75
Max. Negotiated Rate	$937.12
Rate for Payer: Cash Price	$716.63
Rate for Payer: Community Health Alliance Commercial	$937.12
Rate for Payer: Priority Health Commercial	$771.75
Rate for Payer: Priority Health PPO	$771.75

REAMING ROD

Facility

$417.00

Hospital Charge Code	27166997
Hospital Revenue Code	272
Min. Negotiated Rate	$291.90
Max. Negotiated Rate	$354.45
Rate for Payer: Cash Price	$271.05
Rate for Payer: Community Health Alliance Commercial	$354.45
Rate for Payer: Priority Health Commercial	$291.90
Rate for Payer: Priority Health PPO	$291.90

RECEPTORS CATHESPIN

Facility

$130.00

Service Code	HCPCS 82387
Hospital Charge Code	3100495
Hospital Revenue Code	300
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$110.50
Rate for Payer: BCBS BCN 65	$18.96
Rate for Payer: Blue Care Network Medicare Advantage	$18.96
Rate for Payer: Cash Price	$84.50
Rate for Payer: Cash Price	$84.50
Rate for Payer: Community Health Alliance Commercial	$110.50
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$18.96
Rate for Payer: Meridian Health Plan Medicare	$18.96
Rate for Payer: Priority Health Commercial	$91.00
Rate for Payer: Priority Health Medicaid	$18.96
Rate for Payer: Priority Health Medicare	$18.96
Rate for Payer: Priority Health PPO	$91.00
Rate for Payer: United Health Care Medicaid	$18.96
Rate for Payer: United Health Care Medicare Advantage	$8.34

RECEPTORS ESTROGEN

Facility

$196.00

Service Code	HCPCS 84233
Hospital Charge Code	3100496
Hospital Revenue Code	300
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$166.60
Rate for Payer: BCBS BCN 65	$92.27
Rate for Payer: Blue Care Network Medicare Advantage	$92.27
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	$92.27
Rate for Payer: Meridian Health Plan Medicare	$92.27
Rate for Payer: Priority Health Commercial	$137.20
Rate for Payer: Priority Health Medicaid	$92.27
Rate for Payer: Priority Health Medicare	$92.27
Rate for Payer: Priority Health PPO	$137.20
Rate for Payer: United Health Care Medicaid	$92.27
Rate for Payer: United Health Care Medicare Advantage	$40.60

RECEPTORS PROGESTERONE

Facility

$196.00

Service Code	HCPCS 84234
Hospital Charge Code	3100497
Hospital Revenue Code	300
Min. Negotiated Rate	$29.97
Max. Negotiated Rate	$166.60
Rate for Payer: BCBS BCN 65	$68.12
Rate for Payer: Blue Care Network Medicare Advantage	$68.12
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	$68.12
Rate for Payer: Meridian Health Plan Medicare	$68.12
Rate for Payer: Priority Health Commercial	$137.20
Rate for Payer: Priority Health Medicaid	$68.12
Rate for Payer: Priority Health Medicare	$68.12
Rate for Payer: Priority Health PPO	$137.20
Rate for Payer: United Health Care Medicaid	$68.12
Rate for Payer: United Health Care Medicare Advantage	$29.97

RECOVERY ROOM 1/4 HOUR

Facility

$143.00

Hospital Charge Code	7100030
Hospital Revenue Code	710
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$121.55
Rate for Payer: Cash Price	$92.95
Rate for Payer: Community Health Alliance Commercial	$121.55
Rate for Payer: Priority Health Commercial	$100.10
Rate for Payer: Priority Health PPO	$100.10

RED BLOOD CELLS, CMV NEGATIVE

Facility

$441.00

Service Code	HCPCS P9051
Hospital Charge Code	3910200
Hospital Revenue Code	390
Min. Negotiated Rate	$70.03
Max. Negotiated Rate	$374.85
Rate for Payer: BCBS BCN 65	$159.16
Rate for Payer: Blue Care Network Medicare Advantage	$159.16
Rate for Payer: Cash Price	$286.65
Rate for Payer: Cash Price	$286.65
Rate for Payer: Community Health Alliance Commercial	$374.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$159.16
Rate for Payer: Meridian Health Plan Medicare	$159.16
Rate for Payer: Priority Health Commercial	$308.70
Rate for Payer: Priority Health Medicaid	$159.16
Rate for Payer: Priority Health Medicare	$159.16
Rate for Payer: Priority Health PPO	$308.70
Rate for Payer: United Health Care Medicaid	$159.16
Rate for Payer: United Health Care Medicare Advantage	$70.03

RED BLOOD CELLS IRR

Facility

$741.00

Hospital Charge Code	3910052
Hospital Revenue Code	390
Min. Negotiated Rate	$518.70
Max. Negotiated Rate	$629.85
Rate for Payer: Cash Price	$481.65
Rate for Payer: Community Health Alliance Commercial	$629.85
Rate for Payer: Priority Health Commercial	$518.70
Rate for Payer: Priority Health PPO	$518.70

RED BLOOD CELLS,SALINE WASHED

Facility

$305.00

Service Code	HCPCS P9022
Hospital Charge Code	3910180
Hospital Revenue Code	390
Min. Negotiated Rate	$170.28
Max. Negotiated Rate	$387.01
Rate for Payer: BCBS BCN 65	$387.01
Rate for Payer: Blue Care Network Medicare Advantage	$387.01
Rate for Payer: Cash Price	$198.25
Rate for Payer: Cash Price	$198.25
Rate for Payer: Community Health Alliance Commercial	$259.25
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$387.01
Rate for Payer: Meridian Health Plan Medicare	$387.01
Rate for Payer: Priority Health Commercial	$213.50
Rate for Payer: Priority Health Medicaid	$387.01
Rate for Payer: Priority Health Medicare	$387.01
Rate for Payer: Priority Health PPO	$213.50
Rate for Payer: United Health Care Medicaid	$387.01
Rate for Payer: United Health Care Medicare Advantage	$170.28

REDUCER, ETHICON MS512

Facility

$53.00

Hospital Charge Code	27024562
Hospital Revenue Code	272
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$45.05
Rate for Payer: Cash Price	$34.45
Rate for Payer: Community Health Alliance Commercial	$45.05
Rate for Payer: Priority Health Commercial	$37.10
Rate for Payer: Priority Health PPO	$37.10

REDUCING SUBSTANCE

Facility

$44.50

Service Code	HCPCS 84376
Hospital Charge Code	3007140
Hospital Revenue Code	301
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$37.83
Rate for Payer: BCBS BCN 65	$5.78
Rate for Payer: Blue Care Network Medicare Advantage	$5.78
Rate for Payer: Cash Price	$28.93
Rate for Payer: Cash Price	$28.93
Rate for Payer: Community Health Alliance Commercial	$37.83
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$5.78
Rate for Payer: Meridian Health Plan Medicare	$5.78
Rate for Payer: Priority Health Commercial	$31.15
Rate for Payer: Priority Health Medicaid	$5.78
Rate for Payer: Priority Health Medicare	$5.78
Rate for Payer: Priority Health PPO	$31.15
Rate for Payer: United Health Care Medicaid	$5.78
Rate for Payer: United Health Care Medicare Advantage	$2.54

REFLEX 2

Facility

$2.34

Hospital Charge Code	3101858
Hospital Revenue Code	300
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.99
Rate for Payer: Cash Price	$1.52
Rate for Payer: Community Health Alliance Commercial	$1.99
Rate for Payer: Priority Health Commercial	$1.64
Rate for Payer: Priority Health PPO	$1.64

REFLEX 3

Facility

$2.34

Hospital Charge Code	3101859
Hospital Revenue Code	300
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.99
Rate for Payer: Cash Price	$1.52
Rate for Payer: Community Health Alliance Commercial	$1.99
Rate for Payer: Priority Health Commercial	$1.64
Rate for Payer: Priority Health PPO	$1.64

REFLEX 4

Facility

$2.34

Hospital Charge Code	3101860
Hospital Revenue Code	300
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.99
Rate for Payer: Cash Price	$1.52
Rate for Payer: Community Health Alliance Commercial	$1.99
Rate for Payer: Priority Health Commercial	$1.64
Rate for Payer: Priority Health PPO	$1.64

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges