Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

RFCP-11

Facility

$3.09

Hospital Charge Code	3102627
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-12

Facility

$3.09

Hospital Charge Code	3102628
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-13

Facility

$3.09

Hospital Charge Code	3102629
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-14

Facility

$3.09

Hospital Charge Code	3102630
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-15

Facility

$3.09

Hospital Charge Code	3102631
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-16

Facility

$3.09

Hospital Charge Code	3102632
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-17

Facility

$3.09

Hospital Charge Code	3102633
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-18

Facility

$3.24

Hospital Charge Code	3102634
Hospital Revenue Code	300
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.75
Rate for Payer: Cash Price	$2.11
Rate for Payer: Community Health Alliance Commercial	$2.75
Rate for Payer: Priority Health Commercial	$2.27
Rate for Payer: Priority Health PPO	$2.27

RFCP-2

Facility

$3.09

Hospital Charge Code	3102618
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-3

Facility

$3.09

Hospital Charge Code	3102619
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-4

Facility

$3.09

Hospital Charge Code	3102620
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-5

Facility

$3.09

Hospital Charge Code	3102621
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-6

Facility

$3.09

Hospital Charge Code	3102622
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-7

Facility

$3.09

Hospital Charge Code	3102623
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-8

Facility

$3.09

Hospital Charge Code	3102624
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RFCP-9

Facility

$3.09

Hospital Charge Code	3102625
Hospital Revenue Code	300
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.63
Rate for Payer: Cash Price	$2.01
Rate for Payer: Community Health Alliance Commercial	$2.63
Rate for Payer: Priority Health Commercial	$2.16
Rate for Payer: Priority Health PPO	$2.16

RHEUMASSURE

Facility

$43.12

Hospital Charge Code	3102498
Hospital Revenue Code	300
Min. Negotiated Rate	$30.18
Max. Negotiated Rate	$36.65
Rate for Payer: Cash Price	$28.03
Rate for Payer: Community Health Alliance Commercial	$36.65
Rate for Payer: Priority Health Commercial	$30.18
Rate for Payer: Priority Health PPO	$30.18

RH FACTOR/BLOOD

Facility

$34.00

Service Code	HCPCS 86901
Hospital Charge Code	3001120
Hospital Revenue Code	300
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.90
Rate for Payer: BCBS BCN 65	$3.14
Rate for Payer: Blue Care Network Medicare Advantage	$3.14
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	$3.14
Rate for Payer: Meridian Health Plan Medicare	$3.14
Rate for Payer: Priority Health Commercial	$23.80
Rate for Payer: Priority Health Medicaid	$3.14
Rate for Payer: Priority Health Medicare	$3.14
Rate for Payer: Priority Health PPO	$23.80
Rate for Payer: United Health Care Medicaid	$3.14
Rate for Payer: United Health Care Medicare Advantage	$1.38

RH-IBC

Facility

$19.50

Hospital Charge Code	3101934
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

RHOGAM

Facility

$244.00

Service Code	HCPCS 90384
Hospital Charge Code	3910171
Hospital Revenue Code	636
Min. Negotiated Rate	$170.80
Max. Negotiated Rate	$207.40
Rate for Payer: Cash Price	$158.60
Rate for Payer: Community Health Alliance Commercial	$207.40
Rate for Payer: Priority Health Commercial	$170.80
Rate for Payer: Priority Health PPO	$170.80

RHOGAM

Facility

$285.00

Hospital Charge Code	3910170
Hospital Revenue Code	636
Min. Negotiated Rate	$199.50
Max. Negotiated Rate	$242.25
Rate for Payer: Cash Price	$185.25
Rate for Payer: Community Health Alliance Commercial	$242.25
Rate for Payer: Priority Health Commercial	$199.50
Rate for Payer: Priority Health PPO	$199.50

RHOGAM WORKUP

Facility

$150.00

Hospital Charge Code	3001128
Hospital Revenue Code	302
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$127.50
Rate for Payer: Cash Price	$97.50
Rate for Payer: Community Health Alliance Commercial	$127.50
Rate for Payer: Priority Health Commercial	$105.00
Rate for Payer: Priority Health PPO	$105.00

RHYTHM STRIP

Facility

$38.00

Service Code	HCPCS 93041
Hospital Charge Code	7390020
Hospital Revenue Code	730
Min. Negotiated Rate	$26.60
Max. Negotiated Rate	$63.28
Rate for Payer: BCBS BCN 65	$63.28
Rate for Payer: Blue Care Network Medicare Advantage	$63.28
Rate for Payer: Cash Price	$24.70
Rate for Payer: Cash Price	$24.70
Rate for Payer: Community Health Alliance Commercial	$32.30
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$63.28
Rate for Payer: Meridian Health Plan Medicare	$63.28
Rate for Payer: Priority Health Commercial	$26.60
Rate for Payer: Priority Health Medicaid	$63.28
Rate for Payer: Priority Health Medicare	$63.28
Rate for Payer: Priority Health PPO	$26.60
Rate for Payer: United Health Care Medicaid	$63.28
Rate for Payer: United Health Care Medicare Advantage	$27.84

RIA NONANTIBODY

Facility

$37.67

Hospital Charge Code	3100047
Hospital Revenue Code	301
Min. Negotiated Rate	$26.37
Max. Negotiated Rate	$32.02
Rate for Payer: Cash Price	$24.49
Rate for Payer: Community Health Alliance Commercial	$32.02
Rate for Payer: Priority Health Commercial	$26.37
Rate for Payer: Priority Health PPO	$26.37

RIA NONANTIBODY

Facility

$37.67

Hospital Charge Code	3100046
Hospital Revenue Code	301
Min. Negotiated Rate	$26.37
Max. Negotiated Rate	$32.02
Rate for Payer: Cash Price	$24.49
Rate for Payer: Community Health Alliance Commercial	$32.02
Rate for Payer: Priority Health Commercial	$26.37
Rate for Payer: Priority Health PPO	$26.37

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges