Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

TOUCH PREP SURGICAL CONSULT

Facility

$52.00

Hospital Charge Code	3006624
Hospital Revenue Code	312
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$44.20
Rate for Payer: Cash Price	$33.80
Rate for Payer: Community Health Alliance Commercial	$44.20
Rate for Payer: Priority Health Commercial	$36.40
Rate for Payer: Priority Health PPO	$36.40

TOXASSURE SELECT

Facility

$100.00

Hospital Charge Code	3102700
Hospital Revenue Code	300
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$85.00
Rate for Payer: Cash Price	$65.00
Rate for Payer: Community Health Alliance Commercial	$85.00
Rate for Payer: Priority Health Commercial	$70.00
Rate for Payer: Priority Health PPO	$70.00

TOXIN 1

Facility

$90.00

Hospital Charge Code	3003358
Hospital Revenue Code	306
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$76.50
Rate for Payer: Cash Price	$58.50
Rate for Payer: Community Health Alliance Commercial	$76.50
Rate for Payer: Priority Health Commercial	$63.00
Rate for Payer: Priority Health PPO	$63.00

TOXIN 2

Facility

$90.00

Hospital Charge Code	3003359
Hospital Revenue Code	306
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$76.50
Rate for Payer: Cash Price	$58.50
Rate for Payer: Community Health Alliance Commercial	$76.50
Rate for Payer: Priority Health Commercial	$63.00
Rate for Payer: Priority Health PPO	$63.00

TOXOCARIS

Facility

$40.00

Hospital Charge Code	3002148
Hospital Revenue Code	302
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

TOXOPLASMA CONVELESCENT IGG

Facility

$5.29

Service Code	HCPCS 86777
Hospital Charge Code	3008290
Hospital Revenue Code	302
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$15.11
Rate for Payer: BCBS BCN 65	$15.11
Rate for Payer: Blue Care Network Medicare Advantage	$15.11
Rate for Payer: Cash Price	$3.44
Rate for Payer: Cash Price	$3.44
Rate for Payer: Community Health Alliance Commercial	$4.50
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$15.11
Rate for Payer: Meridian Health Plan Medicare	$15.11
Rate for Payer: Priority Health Commercial	$3.70
Rate for Payer: Priority Health Medicaid	$15.11
Rate for Payer: Priority Health Medicare	$15.11
Rate for Payer: Priority Health PPO	$3.70
Rate for Payer: United Health Care Medicaid	$15.11
Rate for Payer: United Health Care Medicare Advantage	$6.65

TOXOPLASMA, IgM

Facility

$7.33

Service Code	HCPCS 86778
Hospital Charge Code	3008285
Hospital Revenue Code	302
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$15.13
Rate for Payer: BCBS BCN 65	$15.13
Rate for Payer: Blue Care Network Medicare Advantage	$15.13
Rate for Payer: Cash Price	$4.76
Rate for Payer: Cash Price	$4.76
Rate for Payer: Community Health Alliance Commercial	$6.23
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$15.13
Rate for Payer: Meridian Health Plan Medicare	$15.13
Rate for Payer: Priority Health Commercial	$5.13
Rate for Payer: Priority Health Medicaid	$15.13
Rate for Payer: Priority Health Medicare	$15.13
Rate for Payer: Priority Health PPO	$5.13
Rate for Payer: United Health Care Medicaid	$15.13
Rate for Payer: United Health Care Medicare Advantage	$6.66

TOXOPLASMA Igm CSF

Facility

$40.75

Hospital Charge Code	3003258
Hospital Revenue Code	302
Min. Negotiated Rate	$28.52
Max. Negotiated Rate	$34.64
Rate for Payer: Cash Price	$26.49
Rate for Payer: Community Health Alliance Commercial	$34.64
Rate for Payer: Priority Health Commercial	$28.52
Rate for Payer: Priority Health PPO	$28.52

TOXOPLASMA TO STATE

Facility

$41.00

Service Code	HCPCS 86777
Hospital Charge Code	3008280
Hospital Revenue Code	302
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$34.85
Rate for Payer: BCBS BCN 65	$15.11
Rate for Payer: Blue Care Network Medicare Advantage	$15.11
Rate for Payer: Cash Price	$26.65
Rate for Payer: Cash Price	$26.65
Rate for Payer: Community Health Alliance Commercial	$34.85
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$15.11
Rate for Payer: Meridian Health Plan Medicare	$15.11
Rate for Payer: Priority Health Commercial	$28.70
Rate for Payer: Priority Health Medicaid	$15.11
Rate for Payer: Priority Health Medicare	$15.11
Rate for Payer: Priority Health PPO	$28.70
Rate for Payer: United Health Care Medicaid	$15.11
Rate for Payer: United Health Care Medicare Advantage	$6.65

TOX SEL 1

Facility

$8.33

Hospital Charge Code	3102701
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 10

Facility

$8.33

Hospital Charge Code	3102710
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 11

Facility

$8.33

Hospital Charge Code	3102711
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 12

Facility

$8.37

Hospital Charge Code	3102712
Hospital Revenue Code	300
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$7.11
Rate for Payer: Cash Price	$5.44
Rate for Payer: Community Health Alliance Commercial	$7.11
Rate for Payer: Priority Health Commercial	$5.86
Rate for Payer: Priority Health PPO	$5.86

TOX SEL 2

Facility

$8.33

Hospital Charge Code	3102702
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 3

Facility

$8.33

Hospital Charge Code	3102703
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 4

Facility

$8.33

Hospital Charge Code	3102704
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 5

Facility

$8.33

Hospital Charge Code	3102705
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 6

Facility

$8.33

Hospital Charge Code	3102706
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 7

Facility

$8.33

Hospital Charge Code	3102707
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 8

Facility

$8.33

Hospital Charge Code	3102708
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TOX SEL 9

Facility

$8.33

Hospital Charge Code	3102709
Hospital Revenue Code	300
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$7.08
Rate for Payer: Cash Price	$5.41
Rate for Payer: Community Health Alliance Commercial	$7.08
Rate for Payer: Priority Health Commercial	$5.83
Rate for Payer: Priority Health PPO	$5.83

TP-1

Facility

$2.44

Hospital Charge Code	3102752
Hospital Revenue Code	300
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$2.07
Rate for Payer: Cash Price	$1.59
Rate for Payer: Community Health Alliance Commercial	$2.07
Rate for Payer: Priority Health Commercial	$1.71
Rate for Payer: Priority Health PPO	$1.71

TP-2

Facility

$2.45

Hospital Charge Code	3102753
Hospital Revenue Code	300
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$2.08
Rate for Payer: Cash Price	$1.59
Rate for Payer: Community Health Alliance Commercial	$2.08
Rate for Payer: Priority Health Commercial	$1.72
Rate for Payer: Priority Health PPO	$1.72

TPMT ENZYME

Facility

$195.00

Hospital Charge Code	3100542
Hospital Revenue Code	301
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$165.75
Rate for Payer: Cash Price	$126.75
Rate for Payer: Community Health Alliance Commercial	$165.75
Rate for Payer: Priority Health Commercial	$136.50
Rate for Payer: Priority Health PPO	$136.50

T-POD PELVIC BINDER

Facility

$328.28

Hospital Charge Code	27085487
Hospital Revenue Code	270
Min. Negotiated Rate	$229.80
Max. Negotiated Rate	$279.04
Rate for Payer: Cash Price	$213.38
Rate for Payer: Community Health Alliance Commercial	$279.04
Rate for Payer: Priority Health Commercial	$229.80
Rate for Payer: Priority Health PPO	$229.80

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges