Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

X THROMBOTIC MICROANGIOPATHY

Facility

$2,268.00

Hospital Charge Code	3102485
Hospital Revenue Code	300
Min. Negotiated Rate	$1,587.60
Max. Negotiated Rate	$1,927.80
Rate for Payer: Cash Price	$1,474.20
Rate for Payer: Community Health Alliance Commercial	$1,927.80
Rate for Payer: Priority Health Commercial	$1,587.60
Rate for Payer: Priority Health PPO	$1,587.60

X THY AB & THY TU

Facility

$6.74

Hospital Charge Code	3101826
Hospital Revenue Code	300
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$5.73
Rate for Payer: Cash Price	$4.38
Rate for Payer: Community Health Alliance Commercial	$5.73
Rate for Payer: Priority Health Commercial	$4.72
Rate for Payer: Priority Health PPO	$4.72

X THYROID AB

Facility

$11.63

Hospital Charge Code	3101819
Hospital Revenue Code	300
Min. Negotiated Rate	$8.14
Max. Negotiated Rate	$9.89
Rate for Payer: Cash Price	$7.56
Rate for Payer: Community Health Alliance Commercial	$9.89
Rate for Payer: Priority Health Commercial	$8.14
Rate for Payer: Priority Health PPO	$8.14

X THYROID ANTIBODIES

Facility

$42.56

Hospital Charge Code	3102641
Hospital Revenue Code	300
Min. Negotiated Rate	$29.79
Max. Negotiated Rate	$36.18
Rate for Payer: Cash Price	$27.66
Rate for Payer: Community Health Alliance Commercial	$36.18
Rate for Payer: Priority Health Commercial	$29.79
Rate for Payer: Priority Health PPO	$29.79

X TICKBORNE DISEASE AB PROFILE

Facility

$140.00

Hospital Charge Code	3102586
Hospital Revenue Code	300
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$119.00
Rate for Payer: Cash Price	$91.00
Rate for Payer: Community Health Alliance Commercial	$119.00
Rate for Payer: Priority Health Commercial	$98.00
Rate for Payer: Priority Health PPO	$98.00

X TISSUE CULTURE

Facility

$150.00

Hospital Charge Code	3102461
Hospital Revenue Code	300
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$127.50
Rate for Payer: Cash Price	$97.50
Rate for Payer: Community Health Alliance Commercial	$127.50
Rate for Payer: Priority Health Commercial	$105.00
Rate for Payer: Priority Health PPO	$105.00

X TISSUE CULTURE ANA-LC

Facility

$32.47

Hospital Charge Code	3102691
Hospital Revenue Code	300
Min. Negotiated Rate	$22.73
Max. Negotiated Rate	$27.60
Rate for Payer: Cash Price	$21.11
Rate for Payer: Community Health Alliance Commercial	$27.60
Rate for Payer: Priority Health Commercial	$22.73
Rate for Payer: Priority Health PPO	$22.73

X TORCH IGG

Facility

$41.73

Hospital Charge Code	3102472
Hospital Revenue Code	300
Min. Negotiated Rate	$29.21
Max. Negotiated Rate	$35.47
Rate for Payer: Cash Price	$27.12
Rate for Payer: Community Health Alliance Commercial	$35.47
Rate for Payer: Priority Health Commercial	$29.21
Rate for Payer: Priority Health PPO	$29.21

X TORCH IGM

Facility

$23.42

Hospital Charge Code	3102478
Hospital Revenue Code	300
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$19.91
Rate for Payer: Cash Price	$15.22
Rate for Payer: Community Health Alliance Commercial	$19.91
Rate for Payer: Priority Health Commercial	$16.39
Rate for Payer: Priority Health PPO	$16.39

X TORCH PANEL IgG

Facility

$156.00

Hospital Charge Code	3009030
Hospital Revenue Code	302
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$132.60
Rate for Payer: Cash Price	$101.40
Rate for Payer: Community Health Alliance Commercial	$132.60
Rate for Payer: Priority Health Commercial	$109.20
Rate for Payer: Priority Health PPO	$109.20

X TYPHOID AB

Facility

$82.43

Hospital Charge Code	3000335
Hospital Revenue Code	300
Min. Negotiated Rate	$57.70
Max. Negotiated Rate	$70.07
Rate for Payer: Cash Price	$53.58
Rate for Payer: Community Health Alliance Commercial	$70.07
Rate for Payer: Priority Health Commercial	$57.70
Rate for Payer: Priority Health PPO	$57.70

X UDS COMPRESHENSIVE

Facility

$109.00

Hospital Charge Code	3101895
Hospital Revenue Code	300
Min. Negotiated Rate	$76.30
Max. Negotiated Rate	$92.65
Rate for Payer: Cash Price	$70.85
Rate for Payer: Community Health Alliance Commercial	$92.65
Rate for Payer: Priority Health Commercial	$76.30
Rate for Payer: Priority Health PPO	$76.30

X URINE PROTEIN ELECTROPHORESI

Facility

$5.70

Hospital Charge Code	3101416
Hospital Revenue Code	300
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$4.84
Rate for Payer: Cash Price	$3.71
Rate for Payer: Community Health Alliance Commercial	$4.84
Rate for Payer: Priority Health Commercial	$3.99
Rate for Payer: Priority Health PPO	$3.99

X USPE REFLEX MONOCLONAL PROTE

Facility

$8.82

Hospital Charge Code	3101644
Hospital Revenue Code	300
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$7.50
Rate for Payer: Cash Price	$5.73
Rate for Payer: Community Health Alliance Commercial	$7.50
Rate for Payer: Priority Health Commercial	$6.17
Rate for Payer: Priority Health PPO	$6.17

X USPE RFX IFE

Facility

$10.56

Hospital Charge Code	3102492
Hospital Revenue Code	300
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$8.98
Rate for Payer: Cash Price	$6.86
Rate for Payer: Community Health Alliance Commercial	$8.98
Rate for Payer: Priority Health Commercial	$7.39
Rate for Payer: Priority Health PPO	$7.39

X US PROSTATE WITH BIOPSY

Facility

$4,498.00

Hospital Charge Code	4000105
Hospital Revenue Code	402
Min. Negotiated Rate	$3,148.60
Max. Negotiated Rate	$3,823.30
Rate for Payer: Cash Price	$2,923.70
Rate for Payer: Community Health Alliance Commercial	$3,823.30
Rate for Payer: Priority Health Commercial	$3,148.60
Rate for Payer: Priority Health PPO	$3,148.60

X USTEKUNUMAB

Facility

$125.00

Hospital Charge Code	3102135
Hospital Revenue Code	300
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$106.25
Rate for Payer: Cash Price	$81.25
Rate for Payer: Community Health Alliance Commercial	$106.25
Rate for Payer: Priority Health Commercial	$87.50
Rate for Payer: Priority Health PPO	$87.50

X VAG PANEL NUSWAB

Facility

$161.00

Hospital Charge Code	3102214
Hospital Revenue Code	300
Min. Negotiated Rate	$112.70
Max. Negotiated Rate	$136.85
Rate for Payer: Cash Price	$104.65
Rate for Payer: Community Health Alliance Commercial	$136.85
Rate for Payer: Priority Health Commercial	$112.70
Rate for Payer: Priority Health PPO	$112.70

X VALPROIC ACID

Facility

$20.99

Hospital Charge Code	3102134
Hospital Revenue Code	300
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$17.84
Rate for Payer: Cash Price	$13.64
Rate for Payer: Community Health Alliance Commercial	$17.84
Rate for Payer: Priority Health Commercial	$14.69
Rate for Payer: Priority Health PPO	$14.69

X VCFS FISH

Facility

$256.00

Hospital Charge Code	3100976
Hospital Revenue Code	310
Min. Negotiated Rate	$179.20
Max. Negotiated Rate	$217.60
Rate for Payer: Cash Price	$166.40
Rate for Payer: Community Health Alliance Commercial	$217.60
Rate for Payer: Priority Health Commercial	$179.20
Rate for Payer: Priority Health PPO	$179.20

X VISIA SEQ LYNCH SYNDROME PAN

Facility

$1,800.00

Hospital Charge Code	3102358
Hospital Revenue Code	300
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$1,530.00
Rate for Payer: Cash Price	$1,170.00
Rate for Payer: Community Health Alliance Commercial	$1,530.00
Rate for Payer: Priority Health Commercial	$1,260.00
Rate for Payer: Priority Health PPO	$1,260.00

X VISTA SEQ MEN 1

Facility

$480.00

Hospital Charge Code	3102405
Hospital Revenue Code	300
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$408.00
Rate for Payer: Cash Price	$312.00
Rate for Payer: Community Health Alliance Commercial	$408.00
Rate for Payer: Priority Health Commercial	$336.00
Rate for Payer: Priority Health PPO	$336.00

X VON WILLEBRAND MULT PANEL

Facility

$116.82

Hospital Charge Code	3101974
Hospital Revenue Code	300
Min. Negotiated Rate	$81.77
Max. Negotiated Rate	$99.30
Rate for Payer: Cash Price	$75.93
Rate for Payer: Community Health Alliance Commercial	$99.30
Rate for Payer: Priority Health Commercial	$81.77
Rate for Payer: Priority Health PPO	$81.77

X WNV IGG & IGM

Facility

$61.00

Hospital Charge Code	3100742
Hospital Revenue Code	302
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$51.85
Rate for Payer: Cash Price	$39.65
Rate for Payer: Community Health Alliance Commercial	$51.85
Rate for Payer: Priority Health Commercial	$42.70
Rate for Payer: Priority Health PPO	$42.70

X WNV IGG/IGM

Facility

$38.00

Hospital Charge Code	3102080
Hospital Revenue Code	300
Min. Negotiated Rate	$26.60
Max. Negotiated Rate	$32.30
Rate for Payer: Cash Price	$24.70
Rate for Payer: Community Health Alliance Commercial	$32.30
Rate for Payer: Priority Health Commercial	$26.60
Rate for Payer: Priority Health PPO	$26.60

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges