Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

X CHL/GC/HPV

Facility

$40.00

Hospital Charge Code	3102051
Hospital Revenue Code	300
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

X CHL/GC NAA SWAB

Facility

$18.00

Hospital Charge Code	3101584
Hospital Revenue Code	306
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$15.30
Rate for Payer: Cash Price	$11.70
Rate for Payer: Community Health Alliance Commercial	$15.30
Rate for Payer: Priority Health Commercial	$12.60
Rate for Payer: Priority Health PPO	$12.60

X CHL/GC NAA THINPREP

Facility

$20.00

Hospital Charge Code	3101587
Hospital Revenue Code	306
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 CHL/GC NAA URINE

Facility

$20.00

Hospital Charge Code	3101590
Hospital Revenue Code	306
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 CHL/GC PHARYNGEAL SWAB

Facility

$18.00

Hospital Charge Code	3102160
Hospital Revenue Code	300
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$15.30
Rate for Payer: Cash Price	$11.70
Rate for Payer: Community Health Alliance Commercial	$15.30
Rate for Payer: Priority Health Commercial	$12.60
Rate for Payer: Priority Health PPO	$12.60

X CHL/GC/TRICH VAG

Facility

$51.00

Hospital Charge Code	3102052
Hospital Revenue Code	300
Min. Negotiated Rate	$35.70
Max. Negotiated Rate	$43.35
Rate for Payer: Cash Price	$33.15
Rate for Payer: Community Health Alliance Commercial	$43.35
Rate for Payer: Priority Health Commercial	$35.70
Rate for Payer: Priority Health PPO	$35.70

X CIRCULATING TUMOR CELL COUNT

Facility

$595.00

Hospital Charge Code	3101249
Hospital Revenue Code	309
Min. Negotiated Rate	$416.50
Max. Negotiated Rate	$505.75
Rate for Payer: Cash Price	$386.75
Rate for Payer: Community Health Alliance Commercial	$505.75
Rate for Payer: Priority Health Commercial	$416.50
Rate for Payer: Priority Health PPO	$416.50

X CK TOTAL + ISOENZYMES

Facility

$5.64

Hospital Charge Code	3101813
Hospital Revenue Code	300
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$4.79
Rate for Payer: Cash Price	$3.67
Rate for Payer: Community Health Alliance Commercial	$4.79
Rate for Payer: Priority Health Commercial	$3.95
Rate for Payer: Priority Health PPO	$3.95

X CLL BY FISH

Facility

$1,198.00

Hospital Charge Code	3100502
Hospital Revenue Code	310
Min. Negotiated Rate	$838.60
Max. Negotiated Rate	$1,018.30
Rate for Payer: Cash Price	$778.70
Rate for Payer: Community Health Alliance Commercial	$1,018.30
Rate for Payer: Priority Health Commercial	$838.60
Rate for Payer: Priority Health PPO	$838.60

X CLL PANEL BY FISH

Facility

$740.00

Hospital Charge Code	3101448
Hospital Revenue Code	310
Min. Negotiated Rate	$518.00
Max. Negotiated Rate	$629.00
Rate for Payer: Cash Price	$481.00
Rate for Payer: Community Health Alliance Commercial	$629.00
Rate for Payer: Priority Health Commercial	$518.00
Rate for Payer: Priority Health PPO	$518.00

X COBALT URINE

Facility

$19.55

Hospital Charge Code	3102188
Hospital Revenue Code	300
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$16.62
Rate for Payer: Cash Price	$12.71
Rate for Payer: Community Health Alliance Commercial	$16.62
Rate for Payer: Priority Health Commercial	$13.69
Rate for Payer: Priority Health PPO	$13.69

XCOCCIDIODES AB

Facility

$61.40

Hospital Charge Code	3102180
Hospital Revenue Code	300
Min. Negotiated Rate	$42.98
Max. Negotiated Rate	$52.19
Rate for Payer: Cash Price	$39.91
Rate for Payer: Community Health Alliance Commercial	$52.19
Rate for Payer: Priority Health Commercial	$42.98
Rate for Payer: Priority Health PPO	$42.98

X COCIDIOIDES IGG IGM

Facility

$54.00

Hospital Charge Code	3100583
Hospital Revenue Code	302
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$45.90
Rate for Payer: Cash Price	$35.10
Rate for Payer: Community Health Alliance Commercial	$45.90
Rate for Payer: Priority Health Commercial	$37.80
Rate for Payer: Priority Health PPO	$37.80

XCOPPER URINE

Facility

$22.48

Hospital Charge Code	3102182
Hospital Revenue Code	300
Min. Negotiated Rate	$15.74
Max. Negotiated Rate	$19.11
Rate for Payer: Cash Price	$14.61
Rate for Payer: Community Health Alliance Commercial	$19.11
Rate for Payer: Priority Health Commercial	$15.74
Rate for Payer: Priority Health PPO	$15.74

X CORTISOL AM/PM

Facility

$4.91

Hospital Charge Code	3102379
Hospital Revenue Code	300
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$4.17
Rate for Payer: Cash Price	$3.19
Rate for Payer: Community Health Alliance Commercial	$4.17
Rate for Payer: Priority Health Commercial	$3.44
Rate for Payer: Priority Health PPO	$3.44

X COXACKIE A IGG AB

Facility

$100.18

Hospital Charge Code	3102384
Hospital Revenue Code	300
Min. Negotiated Rate	$70.13
Max. Negotiated Rate	$85.15
Rate for Payer: Cash Price	$65.12
Rate for Payer: Community Health Alliance Commercial	$85.15
Rate for Payer: Priority Health Commercial	$70.13
Rate for Payer: Priority Health PPO	$70.13

XCREAT DISEASE PANEL URINE

Facility

$7.20

Hospital Charge Code	3100836
Hospital Revenue Code	301
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$6.12
Rate for Payer: Cash Price	$4.68
Rate for Payer: Community Health Alliance Commercial	$6.12
Rate for Payer: Priority Health Commercial	$5.04
Rate for Payer: Priority Health PPO	$5.04

X CREATINE DISORDER PANEL URIN

Facility

$180.00

Hospital Charge Code	3101240
Hospital Revenue Code	301
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$153.00
Rate for Payer: Cash Price	$117.00
Rate for Payer: Community Health Alliance Commercial	$153.00
Rate for Payer: Priority Health Commercial	$126.00
Rate for Payer: Priority Health PPO	$126.00

X CREATINE DISORDERS PANEL URI

Facility

$177.00

Hospital Charge Code	3100837
Hospital Revenue Code	301
Min. Negotiated Rate	$123.90
Max. Negotiated Rate	$150.45
Rate for Payer: Cash Price	$115.05
Rate for Payer: Community Health Alliance Commercial	$150.45
Rate for Payer: Priority Health Commercial	$123.90
Rate for Payer: Priority Health PPO	$123.90

X CRYGLOBULIN ELECTROPHORESIS

Facility

$248.00

Hospital Charge Code	3002925
Hospital Revenue Code	301
Min. Negotiated Rate	$173.60
Max. Negotiated Rate	$210.80
Rate for Payer: Cash Price	$161.20
Rate for Payer: Community Health Alliance Commercial	$210.80
Rate for Payer: Priority Health Commercial	$173.60
Rate for Payer: Priority Health PPO	$173.60

X CSF PROT ELEC

Facility

$15.32

Hospital Charge Code	3102186
Hospital Revenue Code	300
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$13.02
Rate for Payer: Cash Price	$9.96
Rate for Payer: Community Health Alliance Commercial	$13.02
Rate for Payer: Priority Health Commercial	$10.72
Rate for Payer: Priority Health PPO	$10.72

X CULTRE BF W CYSTOSPIN GS LC

Facility

$32.00

Hospital Charge Code	3102438
Hospital Revenue Code	300
Min. Negotiated Rate	$22.40
Max. Negotiated Rate	$27.20
Rate for Payer: Cash Price	$20.80
Rate for Payer: Community Health Alliance Commercial	$27.20
Rate for Payer: Priority Health Commercial	$22.40
Rate for Payer: Priority Health PPO	$22.40

X CULTURE, BF/GS/-LC

Facility

$15.91

Hospital Charge Code	3102440
Hospital Revenue Code	300
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$13.52
Rate for Payer: Cash Price	$10.34
Rate for Payer: Community Health Alliance Commercial	$13.52
Rate for Payer: Priority Health Commercial	$11.14
Rate for Payer: Priority Health PPO	$11.14

X CULTURE STOOL-LC

Facility

$20.36

Hospital Charge Code	3102424
Hospital Revenue Code	300
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$17.31
Rate for Payer: Cash Price	$13.23
Rate for Payer: Community Health Alliance Commercial	$17.31
Rate for Payer: Priority Health Commercial	$14.25
Rate for Payer: Priority Health PPO	$14.25

X CUSTOM NGS PANEL-LC

Facility

$360.00

Hospital Charge Code	3102695
Hospital Revenue Code	300
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$306.00
Rate for Payer: Cash Price	$234.00
Rate for Payer: Community Health Alliance Commercial	$306.00
Rate for Payer: Priority Health Commercial	$252.00
Rate for Payer: Priority Health PPO	$252.00

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges