Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

X BACTERIAL VAGINOSIS NAA

Facility

$143.00

Hospital Charge Code	3102082
Hospital Revenue Code	300
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

X BARTONELLA AB PROFILE

Facility

$14.66

Hospital Charge Code	3101607
Hospital Revenue Code	300
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$12.46
Rate for Payer: Cash Price	$9.53
Rate for Payer: Community Health Alliance Commercial	$12.46
Rate for Payer: Priority Health Commercial	$10.26
Rate for Payer: Priority Health PPO	$10.26

X BARTONELLA HENSELAE

Facility

$14.69

Hospital Charge Code	3101832
Hospital Revenue Code	300
Min. Negotiated Rate	$10.28
Max. Negotiated Rate	$12.49
Rate for Payer: Cash Price	$9.55
Rate for Payer: Community Health Alliance Commercial	$12.49
Rate for Payer: Priority Health Commercial	$10.28
Rate for Payer: Priority Health PPO	$10.28

X BCELL AND TCELL GENE PCR

Facility

$170.00

Hospital Charge Code	3100687
Hospital Revenue Code	300
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$144.50
Rate for Payer: Cash Price	$110.50
Rate for Payer: Community Health Alliance Commercial	$144.50
Rate for Payer: Priority Health Commercial	$119.00
Rate for Payer: Priority Health PPO	$119.00

X B-CELL CLONALITY

Facility

$326.00

Hospital Charge Code	3101312
Hospital Revenue Code	300
Min. Negotiated Rate	$228.20
Max. Negotiated Rate	$277.10
Rate for Payer: Cash Price	$211.90
Rate for Payer: Community Health Alliance Commercial	$277.10
Rate for Payer: Priority Health Commercial	$228.20
Rate for Payer: Priority Health PPO	$228.20

X BCR ABL MAJ PCR

Facility

$100.00

Hospital Charge Code	3102332
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

X BETA-2 GLYCOPROT 1IGA,IGG,I

Facility

$12.21

Hospital Charge Code	3100850
Hospital Revenue Code	300
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$10.38
Rate for Payer: Cash Price	$7.94
Rate for Payer: Community Health Alliance Commercial	$10.38
Rate for Payer: Priority Health Commercial	$8.55
Rate for Payer: Priority Health PPO	$8.55

X BETA 2 GLYCOPROTEIN IgG/IgM

Facility

$8.14

Hospital Charge Code	3101435
Hospital Revenue Code	300
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$6.92
Rate for Payer: Cash Price	$5.29
Rate for Payer: Community Health Alliance Commercial	$6.92
Rate for Payer: Priority Health Commercial	$5.70
Rate for Payer: Priority Health PPO	$5.70

X BETA AMYLOID 42/40 RATIO

Facility

$160.00

Hospital Charge Code	3102583
Hospital Revenue Code	300
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$136.00
Rate for Payer: Cash Price	$104.00
Rate for Payer: Community Health Alliance Commercial	$136.00
Rate for Payer: Priority Health Commercial	$112.00
Rate for Payer: Priority Health PPO	$112.00

X B HERMSII AB

Facility

$80.00

Hospital Charge Code	3100988
Hospital Revenue Code	302
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$68.00
Rate for Payer: Cash Price	$52.00
Rate for Payer: Community Health Alliance Commercial	$68.00
Rate for Payer: Priority Health Commercial	$56.00
Rate for Payer: Priority Health PPO	$56.00

X BIOAVAILABLE TESTOSTERONE

Facility

$48.42

Hospital Charge Code	3102015
Hospital Revenue Code	300
Min. Negotiated Rate	$33.89
Max. Negotiated Rate	$41.16
Rate for Payer: Cash Price	$31.47
Rate for Payer: Community Health Alliance Commercial	$41.16
Rate for Payer: Priority Health Commercial	$33.89
Rate for Payer: Priority Health PPO	$33.89

X BIRC2-MALT1 TRANSLOCATION

Facility

$458.00

Hospital Charge Code	3100674
Hospital Revenue Code	300
Min. Negotiated Rate	$320.60
Max. Negotiated Rate	$389.30
Rate for Payer: Cash Price	$297.70
Rate for Payer: Community Health Alliance Commercial	$389.30
Rate for Payer: Priority Health Commercial	$320.60
Rate for Payer: Priority Health PPO	$320.60

X BLOOD ID MIC REFERRED

Facility

$64.00

Hospital Charge Code	3100814
Hospital Revenue Code	306
Min. Negotiated Rate	$44.80
Max. Negotiated Rate	$54.40
Rate for Payer: Cash Price	$41.60
Rate for Payer: Community Health Alliance Commercial	$54.40
Rate for Payer: Priority Health Commercial	$44.80
Rate for Payer: Priority Health PPO	$44.80

X BORDETELLA igg/igm

Facility

$31.48

Hospital Charge Code	3000850
Hospital Revenue Code	302
Min. Negotiated Rate	$22.04
Max. Negotiated Rate	$26.76
Rate for Payer: Cash Price	$20.46
Rate for Payer: Community Health Alliance Commercial	$26.76
Rate for Payer: Priority Health Commercial	$22.04
Rate for Payer: Priority Health PPO	$22.04

XBRAF CODON 600 MUTATION DETEC

Facility

$320.00

Hospital Charge Code	3101346
Hospital Revenue Code	310
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$272.00
Rate for Payer: Cash Price	$208.00
Rate for Payer: Community Health Alliance Commercial	$272.00
Rate for Payer: Priority Health Commercial	$224.00
Rate for Payer: Priority Health PPO	$224.00

X CALCIUM 24 HR W/CREATININE

Facility

$7.75

Hospital Charge Code	3102414
Hospital Revenue Code	300
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$6.59
Rate for Payer: Cash Price	$5.04
Rate for Payer: Community Health Alliance Commercial	$6.59
Rate for Payer: Priority Health Commercial	$5.42
Rate for Payer: Priority Health PPO	$5.42

X CARBAMAZEPINE FREE AND TOTAL

Facility

$24.73

Hospital Charge Code	3100811
Hospital Revenue Code	300
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$21.02
Rate for Payer: Cash Price	$16.07
Rate for Payer: Community Health Alliance Commercial	$21.02
Rate for Payer: Priority Health Commercial	$17.31
Rate for Payer: Priority Health PPO	$17.31

X CARNITINE PANEL PLASMA

Facility

$581.00

Hospital Charge Code	3100833
Hospital Revenue Code	301
Min. Negotiated Rate	$406.70
Max. Negotiated Rate	$493.85
Rate for Payer: Cash Price	$377.65
Rate for Payer: Community Health Alliance Commercial	$493.85
Rate for Payer: Priority Health Commercial	$406.70
Rate for Payer: Priority Health PPO	$406.70

X CAT SCRATCH-SMNF

Facility

$52.00

Hospital Charge Code	3101167
Hospital Revenue Code	302
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

X CD57 AND NK CELLS

Facility

$182.50

Hospital Charge Code	3101160
Hospital Revenue Code	300
Min. Negotiated Rate	$127.75
Max. Negotiated Rate	$155.12
Rate for Payer: Cash Price	$118.63
Rate for Payer: Community Health Alliance Commercial	$155.12
Rate for Payer: Priority Health Commercial	$127.75
Rate for Payer: Priority Health PPO	$127.75

X CD57 SHORT PANEL

Facility

$85.00

Hospital Charge Code	3102454
Hospital Revenue Code	300
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$72.25
Rate for Payer: Cash Price	$55.25
Rate for Payer: Community Health Alliance Commercial	$72.25
Rate for Payer: Priority Health Commercial	$59.50
Rate for Payer: Priority Health PPO	$59.50

X CDIF AG TOXIN

Facility

$77.00

Hospital Charge Code	3100765
Hospital Revenue Code	306
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$65.45
Rate for Payer: Cash Price	$50.05
Rate for Payer: Community Health Alliance Commercial	$65.45
Rate for Payer: Priority Health Commercial	$53.90
Rate for Payer: Priority Health PPO	$53.90

X CHARGE LYME AB/LINE REFLEX

Facility

$15.80

Hospital Charge Code	3101892
Hospital Revenue Code	300
Min. Negotiated Rate	$11.06
Max. Negotiated Rate	$13.43
Rate for Payer: Cash Price	$10.27
Rate for Payer: Community Health Alliance Commercial	$13.43
Rate for Payer: Priority Health Commercial	$11.06
Rate for Payer: Priority Health PPO	$11.06

X CHLAMYDIA CULTURE LC

Facility

$20.00

Hospital Charge Code	3102167
Hospital Revenue Code	300
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$17.00
Rate for Payer: Cash Price	$13.00
Rate for Payer: Community Health Alliance Commercial	$17.00
Rate for Payer: Priority Health Commercial	$14.00
Rate for Payer: Priority Health PPO	$14.00

X CHLAMYDIA TRACHOMATIS/MEISS

Facility

$24.00

Hospital Charge Code	3101502
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

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges