Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

SUPRA TUBE & PLATE

Facility

$859.00

Hospital Charge Code	27814050
Hospital Revenue Code	278
Min. Negotiated Rate	$601.30
Max. Negotiated Rate	$730.15
Rate for Payer: Cash Price	$558.35
Rate for Payer: Community Health Alliance Commercial	$730.15
Rate for Payer: Priority Health Commercial	$601.30
Rate for Payer: Priority Health PPO	$601.30

SURCH-LITE #H8372

Facility

$131.00

Hospital Charge Code	27265544
Hospital Revenue Code	272
Min. Negotiated Rate	$91.70
Max. Negotiated Rate	$111.35
Rate for Payer: Cash Price	$85.15
Rate for Payer: Community Health Alliance Commercial	$111.35
Rate for Payer: Priority Health Commercial	$91.70
Rate for Payer: Priority Health PPO	$91.70

SURE CATH

Facility

$56.00

Hospital Charge Code	27014928
Hospital Revenue Code	270
Min. Negotiated Rate	$39.20
Max. Negotiated Rate	$47.60
Rate for Payer: Cash Price	$36.40
Rate for Payer: Community Health Alliance Commercial	$47.60
Rate for Payer: Priority Health Commercial	$39.20
Rate for Payer: Priority Health PPO	$39.20

SUREPATH PAP DIAGNOSTIC

Facility

$106.00

Service Code	HCPCS 88142
Hospital Charge Code	3007660
Hospital Revenue Code	311
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$90.10
Rate for Payer: BCBS BCN 65	$21.27
Rate for Payer: Blue Care Network Medicare Advantage	$21.27
Rate for Payer: Cash Price	$68.90
Rate for Payer: Cash Price	$68.90
Rate for Payer: Community Health Alliance Commercial	$90.10
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$21.27
Rate for Payer: Meridian Health Plan Medicare	$21.27
Rate for Payer: Priority Health Commercial	$74.20
Rate for Payer: Priority Health Medicaid	$21.27
Rate for Payer: Priority Health Medicare	$21.27
Rate for Payer: Priority Health PPO	$74.20
Rate for Payer: United Health Care Medicaid	$21.27
Rate for Payer: United Health Care Medicare Advantage	$9.36

SURE TRANS 3/16" DRAIN

Facility

$634.00

Hospital Charge Code	27262560
Hospital Revenue Code	272
Min. Negotiated Rate	$443.80
Max. Negotiated Rate	$538.90
Rate for Payer: Cash Price	$412.10
Rate for Payer: Community Health Alliance Commercial	$538.90
Rate for Payer: Priority Health Commercial	$443.80
Rate for Payer: Priority Health PPO	$443.80

SUR-FIT APPLIANCE, O.R. SET I

Facility

$115.00

Hospital Charge Code	27011601
Hospital Revenue Code	270
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$97.75
Rate for Payer: Cash Price	$74.75
Rate for Payer: Community Health Alliance Commercial	$97.75
Rate for Payer: Priority Health Commercial	$80.50
Rate for Payer: Priority Health PPO	$80.50

SUR-FIT APPLIANCE, O.R. SET II

Facility

$98.00

Hospital Charge Code	27011619
Hospital Revenue Code	270
Min. Negotiated Rate	$68.60
Max. Negotiated Rate	$83.30
Rate for Payer: Cash Price	$63.70
Rate for Payer: Community Health Alliance Commercial	$83.30
Rate for Payer: Priority Health Commercial	$68.60
Rate for Payer: Priority Health PPO	$68.60

SURGICAL PATTIES

Facility

$40.00

Hospital Charge Code	27061154
Hospital Revenue Code	272
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$34.00
Rate for Payer: Cash Price	$26.00
Rate for Payer: Community Health Alliance Commercial	$34.00
Rate for Payer: Priority Health Commercial	$28.00
Rate for Payer: Priority Health PPO	$28.00

SURGICAL STAYS

Facility

$198.00

Hospital Charge Code	27060636
Hospital Revenue Code	272
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$168.30
Rate for Payer: Cash Price	$128.70
Rate for Payer: Community Health Alliance Commercial	$168.30
Rate for Payer: Priority Health Commercial	$138.60
Rate for Payer: Priority Health PPO	$138.60

SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED

Facility

$2,977.57

Service Code	CPT 46280
Hospital Revenue Code	360
Min. Negotiated Rate	$1,310.13
Max. Negotiated Rate	$2,977.57
Rate for Payer: BCBS BCN 65	$2,977.57
Rate for Payer: Blue Care Network Medicare Advantage	$2,977.57
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$2,977.57
Rate for Payer: Meridian Health Plan Medicare	$2,977.57
Rate for Payer: Priority Health Medicaid	$2,977.57
Rate for Payer: Priority Health Medicare	$2,977.57
Rate for Payer: United Health Care Medicaid	$2,977.57
Rate for Payer: United Health Care Medicare Advantage	$1,310.13

SURGIFLEX WAVE XP PUMP

Facility

$120.00

Hospital Charge Code	27274448
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$102.00
Rate for Payer: Cash Price	$78.00
Rate for Payer: Community Health Alliance Commercial	$102.00
Rate for Payer: Priority Health Commercial	$84.00
Rate for Payer: Priority Health PPO	$84.00

SURGIFOAM SZ 12-7

Facility

$9.75

Hospital Charge Code	27282425
Hospital Revenue Code	272
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$8.29
Rate for Payer: Cash Price	$6.34
Rate for Payer: Community Health Alliance Commercial	$8.29
Rate for Payer: Priority Health Commercial	$6.83
Rate for Payer: Priority Health PPO	$6.83

SUSCEPT AER & ANAEROBIC

Facility

$9.50

Hospital Charge Code	3101960
Hospital Revenue Code	300
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$8.07
Rate for Payer: Cash Price	$6.18
Rate for Payer: Community Health Alliance Commercial	$8.07
Rate for Payer: Priority Health Commercial	$6.65
Rate for Payer: Priority Health PPO	$6.65

SUSCEPTIBILITY DISK METHOD

Facility

$5.20

Hospital Charge Code	3101582
Hospital Revenue Code	306
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$4.42
Rate for Payer: Cash Price	$3.38
Rate for Payer: Community Health Alliance Commercial	$4.42
Rate for Payer: Priority Health Commercial	$3.64
Rate for Payer: Priority Health PPO	$3.64

SUSCEPTIBILITY ENZYME DETECT

Facility

$24.00

Hospital Charge Code	3100934
Hospital Revenue Code	306
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

SUSCEPTIBILITY YEAST BY BROTH

Facility

$75.00

Hospital Charge Code	3101425
Hospital Revenue Code	306
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$63.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Community Health Alliance Commercial	$63.75
Rate for Payer: Priority Health Commercial	$52.50
Rate for Payer: Priority Health PPO	$52.50

Susc Haemophilus

Facility

$33.80

Hospital Charge Code	31027579
Hospital Revenue Code	300
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$28.73
Rate for Payer: Cash Price	$21.97
Rate for Payer: Community Health Alliance Commercial	$28.73
Rate for Payer: Priority Health Commercial	$23.66
Rate for Payer: Priority Health PPO	$23.66

SUSPEND TUTOPLAST

Facility

$1,636.00

Hospital Charge Code	27262966
Hospital Revenue Code	272
Min. Negotiated Rate	$1,145.20
Max. Negotiated Rate	$1,390.60
Rate for Payer: Cash Price	$1,063.40
Rate for Payer: Community Health Alliance Commercial	$1,390.60
Rate for Payer: Priority Health Commercial	$1,145.20
Rate for Payer: Priority Health PPO	$1,145.20

SWAN GANZ KIT

Facility

$617.00

Hospital Charge Code	27022343
Hospital Revenue Code	272
Min. Negotiated Rate	$431.90
Max. Negotiated Rate	$524.45
Rate for Payer: Cash Price	$401.05
Rate for Payer: Community Health Alliance Commercial	$524.45
Rate for Payer: Priority Health Commercial	$431.90
Rate for Payer: Priority Health PPO	$431.90

SWAN-GANZ THERMODILUTION CATH

Facility

$158.00

Service Code	HCPCS C1751
Hospital Charge Code	27014100
Hospital Revenue Code	272
Min. Negotiated Rate	$110.60
Max. Negotiated Rate	$134.30
Rate for Payer: Cash Price	$102.70
Rate for Payer: Community Health Alliance Commercial	$134.30
Rate for Payer: Priority Health Commercial	$110.60
Rate for Payer: Priority Health PPO	$110.60

SWANSON FINGER JOINT IMPLANT

Facility

$1,977.00

Hospital Charge Code	27863643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,383.90
Max. Negotiated Rate	$1,680.45
Rate for Payer: Cash Price	$1,285.05
Rate for Payer: Community Health Alliance Commercial	$1,680.45
Rate for Payer: Priority Health Commercial	$1,383.90
Rate for Payer: Priority Health PPO	$1,383.90

SWANSON SUTURE PASSER

Facility

$124.00

Hospital Charge Code	27264488
Hospital Revenue Code	272
Min. Negotiated Rate	$86.80
Max. Negotiated Rate	$105.40
Rate for Payer: Cash Price	$80.60
Rate for Payer: Community Health Alliance Commercial	$105.40
Rate for Payer: Priority Health Commercial	$86.80
Rate for Payer: Priority Health PPO	$86.80

SYNTHES ANKLE TRAUMA

Facility

$3,944.00

Hospital Charge Code	27882805
Hospital Revenue Code	278
Min. Negotiated Rate	$2,760.80
Max. Negotiated Rate	$3,352.40
Rate for Payer: Cash Price	$2,563.60
Rate for Payer: Community Health Alliance Commercial	$3,352.40
Rate for Payer: Priority Health Commercial	$2,760.80
Rate for Payer: Priority Health PPO	$2,760.80

SYRINGE,INFLATION 60CC

Facility

$124.00

Hospital Charge Code	27263291
Hospital Revenue Code	272
Min. Negotiated Rate	$86.80
Max. Negotiated Rate	$105.40
Rate for Payer: Cash Price	$80.60
Rate for Payer: Community Health Alliance Commercial	$105.40
Rate for Payer: Priority Health Commercial	$86.80
Rate for Payer: Priority Health PPO	$86.80

T3 AB

Facility

$145.95

Hospital Charge Code	3101613
Hospital Revenue Code	300
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$124.06
Rate for Payer: Cash Price	$94.87
Rate for Payer: Community Health Alliance Commercial	$124.06
Rate for Payer: Priority Health Commercial	$102.17
Rate for Payer: Priority Health PPO	$102.17

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges