Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

X CYCLIC AMP

Facility

$24.31

Hospital Charge Code	3101817
Hospital Revenue Code	300
Min. Negotiated Rate	$17.02
Max. Negotiated Rate	$20.66
Rate for Payer: Cash Price	$15.80
Rate for Payer: Community Health Alliance Commercial	$20.66
Rate for Payer: Priority Health Commercial	$17.02
Rate for Payer: Priority Health PPO	$17.02

X CYTOKINE PANEL

Facility

$340.00

Hospital Charge Code	3101517
Hospital Revenue Code	300
Min. Negotiated Rate	$238.00
Max. Negotiated Rate	$289.00
Rate for Payer: Cash Price	$221.00
Rate for Payer: Community Health Alliance Commercial	$289.00
Rate for Payer: Priority Health Commercial	$238.00
Rate for Payer: Priority Health PPO	$238.00

X CYTOKINES PANEL MONOKINES

Facility

$240.00

Hospital Charge Code	3101464
Hospital Revenue Code	300
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$204.00
Rate for Payer: Cash Price	$156.00
Rate for Payer: Community Health Alliance Commercial	$204.00
Rate for Payer: Priority Health Commercial	$168.00
Rate for Payer: Priority Health PPO	$168.00

X DAT-MONO-IBC

Facility

$50.00

Hospital Charge Code	3101935
Hospital Revenue Code	300
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$42.50
Rate for Payer: Cash Price	$32.50
Rate for Payer: Community Health Alliance Commercial	$42.50
Rate for Payer: Priority Health Commercial	$35.00
Rate for Payer: Priority Health PPO	$35.00

X DENGUE FEVER IGG IGN

Facility

$78.50

Hospital Charge Code	3102191
Hospital Revenue Code	300
Min. Negotiated Rate	$54.95
Max. Negotiated Rate	$66.72
Rate for Payer: Cash Price	$51.03
Rate for Payer: Community Health Alliance Commercial	$66.72
Rate for Payer: Priority Health Commercial	$54.95
Rate for Payer: Priority Health PPO	$54.95

XDESMOGLEIN 1&3 AB IN PEMPHIGU

Facility

$104.12

Hospital Charge Code	3101166
Hospital Revenue Code	300
Min. Negotiated Rate	$72.88
Max. Negotiated Rate	$88.50
Rate for Payer: Cash Price	$67.68
Rate for Payer: Community Health Alliance Commercial	$88.50
Rate for Payer: Priority Health Commercial	$72.88
Rate for Payer: Priority Health PPO	$72.88

X DIP TET HFLUB IGG

Facility

$62.00

Hospital Charge Code	3100785
Hospital Revenue Code	300
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$52.70
Rate for Payer: Cash Price	$40.30
Rate for Payer: Community Health Alliance Commercial	$52.70
Rate for Payer: Priority Health Commercial	$43.40
Rate for Payer: Priority Health PPO	$43.40

X DIP TET HINFLU AB IGG

Facility

$357.25

Hospital Charge Code	3101059
Hospital Revenue Code	300
Min. Negotiated Rate	$250.07
Max. Negotiated Rate	$303.66
Rate for Payer: Cash Price	$232.21
Rate for Payer: Community Health Alliance Commercial	$303.66
Rate for Payer: Priority Health Commercial	$250.07
Rate for Payer: Priority Health PPO	$250.07

X D,L METHAMPHETAMINE

Facility

$30.00

Hospital Charge Code	3101572
Hospital Revenue Code	300
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$25.50
Rate for Payer: Cash Price	$19.50
Rate for Payer: Community Health Alliance Commercial	$25.50
Rate for Payer: Priority Health Commercial	$21.00
Rate for Payer: Priority Health PPO	$21.00

XEGFR DETECTION BY PYROSEQUENC

Facility

$510.00

Hospital Charge Code	3101357
Hospital Revenue Code	310
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$433.50
Rate for Payer: Cash Price	$331.50
Rate for Payer: Community Health Alliance Commercial	$433.50
Rate for Payer: Priority Health Commercial	$357.00
Rate for Payer: Priority Health PPO	$357.00

X EHLERS DANLOS SYNDROME CHARG

Facility

$1,315.00

Hospital Charge Code	3102004
Hospital Revenue Code	300
Min. Negotiated Rate	$920.50
Max. Negotiated Rate	$1,117.75
Rate for Payer: Cash Price	$854.75
Rate for Payer: Community Health Alliance Commercial	$1,117.75
Rate for Payer: Priority Health Commercial	$920.50
Rate for Payer: Priority Health PPO	$920.50

X ELECTRO W IMMUNOFIX URINE

Facility

$143.00

Hospital Charge Code	3100820
Hospital Revenue Code	302
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 ENA

Facility

$9.54

Hospital Charge Code	3101239
Hospital Revenue Code	302
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$8.11
Rate for Payer: Cash Price	$6.20
Rate for Payer: Community Health Alliance Commercial	$8.11
Rate for Payer: Priority Health Commercial	$6.68
Rate for Payer: Priority Health PPO	$6.68

X EPSTEIN BARR PANEL

Facility

$24.37

Hospital Charge Code	3004030
Hospital Revenue Code	302
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$20.71
Rate for Payer: Cash Price	$15.84
Rate for Payer: Community Health Alliance Commercial	$20.71
Rate for Payer: Priority Health Commercial	$17.06
Rate for Payer: Priority Health PPO	$17.06

X ESTRADIOL FREE

Facility

$33.60

Hospital Charge Code	3101538
Hospital Revenue Code	300
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$28.56
Rate for Payer: Cash Price	$21.84
Rate for Payer: Community Health Alliance Commercial	$28.56
Rate for Payer: Priority Health Commercial	$23.52
Rate for Payer: Priority Health PPO	$23.52

X ESTRADIOL LC/MS AND ESTRONE

Facility

$55.91

Hospital Charge Code	3101476
Hospital Revenue Code	300
Min. Negotiated Rate	$39.14
Max. Negotiated Rate	$47.52
Rate for Payer: Cash Price	$36.34
Rate for Payer: Community Health Alliance Commercial	$47.52
Rate for Payer: Priority Health Commercial	$39.14
Rate for Payer: Priority Health PPO	$39.14

X ETHYLENE GLYCOL

Facility

$12.36

Hospital Charge Code	3004075
Hospital Revenue Code	301
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$10.51
Rate for Payer: Cash Price	$8.03
Rate for Payer: Community Health Alliance Commercial	$10.51
Rate for Payer: Priority Health Commercial	$8.65
Rate for Payer: Priority Health PPO	$8.65

X FAMILIAL HYPEERCHOLECTEREMIA

Facility

$14.50

Hospital Charge Code	3102524
Hospital Revenue Code	300
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$12.32
Rate for Payer: Cash Price	$9.43
Rate for Payer: Community Health Alliance Commercial	$12.32
Rate for Payer: Priority Health Commercial	$10.15
Rate for Payer: Priority Health PPO	$10.15

X FEB AB PANEL

Facility

$113.86

Hospital Charge Code	3100808
Hospital Revenue Code	300
Min. Negotiated Rate	$79.70
Max. Negotiated Rate	$96.78
Rate for Payer: Cash Price	$74.01
Rate for Payer: Community Health Alliance Commercial	$96.78
Rate for Payer: Priority Health Commercial	$79.70
Rate for Payer: Priority Health PPO	$79.70

X FETAL MATERNAL QUANT FLOW CY

Facility

$47.20

Hospital Charge Code	3101227
Hospital Revenue Code	310
Min. Negotiated Rate	$33.04
Max. Negotiated Rate	$40.12
Rate for Payer: Cash Price	$30.68
Rate for Payer: Community Health Alliance Commercial	$40.12
Rate for Payer: Priority Health Commercial	$33.04
Rate for Payer: Priority Health PPO	$33.04

X FLOW MARKERS

Facility

$131.56

Hospital Charge Code	3101970
Hospital Revenue Code	300
Min. Negotiated Rate	$92.09
Max. Negotiated Rate	$111.83
Rate for Payer: Cash Price	$85.51
Rate for Payer: Community Health Alliance Commercial	$111.83
Rate for Payer: Priority Health Commercial	$92.09
Rate for Payer: Priority Health PPO	$92.09

X FLOW MARKERS

Facility

$101.20

Hospital Charge Code	3101969
Hospital Revenue Code	300
Min. Negotiated Rate	$70.84
Max. Negotiated Rate	$86.02
Rate for Payer: Cash Price	$65.78
Rate for Payer: Community Health Alliance Commercial	$86.02
Rate for Payer: Priority Health Commercial	$70.84
Rate for Payer: Priority Health PPO	$70.84

X FLOW MARKERS

Facility

$40.48

Hospital Charge Code	3101968
Hospital Revenue Code	300
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$34.41
Rate for Payer: Cash Price	$26.31
Rate for Payer: Community Health Alliance Commercial	$34.41
Rate for Payer: Priority Health Commercial	$28.34
Rate for Payer: Priority Health PPO	$28.34

X FLOW MARKER X 15

Facility

$151.80

Hospital Charge Code	3101873
Hospital Revenue Code	300
Min. Negotiated Rate	$106.26
Max. Negotiated Rate	$129.03
Rate for Payer: Cash Price	$98.67
Rate for Payer: Community Health Alliance Commercial	$129.03
Rate for Payer: Priority Health Commercial	$106.26
Rate for Payer: Priority Health PPO	$106.26

X FLOW MARKER X 2

Facility

$20.24

Hospital Charge Code	3102123
Hospital Revenue Code	300
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$17.20
Rate for Payer: Cash Price	$13.16
Rate for Payer: Community Health Alliance Commercial	$17.20
Rate for Payer: Priority Health Commercial	$14.17
Rate for Payer: Priority Health PPO	$14.17

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges