Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

X YERSINIA GAM IMMUNOBLOT

Facility

$203.90

Hospital Charge Code	3101852
Hospital Revenue Code	300
Min. Negotiated Rate	$142.73
Max. Negotiated Rate	$173.31
Rate for Payer: Cash Price	$132.54
Rate for Payer: Community Health Alliance Commercial	$173.31
Rate for Payer: Priority Health Commercial	$142.73
Rate for Payer: Priority Health PPO	$142.73

Y CHROMOSOME MICRODELETION

Facility

$244.00

Hospital Charge Code	3100715
Hospital Revenue Code	310
Min. Negotiated Rate	$170.80
Max. Negotiated Rate	$207.40
Rate for Payer: Cash Price	$158.60
Rate for Payer: Community Health Alliance Commercial	$207.40
Rate for Payer: Priority Health Commercial	$170.80
Rate for Payer: Priority Health PPO	$170.80

YER-1

Facility

$67.96

Hospital Charge Code	3101853
Hospital Revenue Code	300
Min. Negotiated Rate	$47.57
Max. Negotiated Rate	$57.77
Rate for Payer: Cash Price	$44.17
Rate for Payer: Community Health Alliance Commercial	$57.77
Rate for Payer: Priority Health Commercial	$47.57
Rate for Payer: Priority Health PPO	$47.57

YER-2

Facility

$67.96

Hospital Charge Code	3101854
Hospital Revenue Code	300
Min. Negotiated Rate	$47.57
Max. Negotiated Rate	$57.77
Rate for Payer: Cash Price	$44.17
Rate for Payer: Community Health Alliance Commercial	$57.77
Rate for Payer: Priority Health Commercial	$47.57
Rate for Payer: Priority Health PPO	$47.57

YER-3

Facility

$67.98

Hospital Charge Code	3101855
Hospital Revenue Code	300
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$57.78
Rate for Payer: Cash Price	$44.19
Rate for Payer: Community Health Alliance Commercial	$57.78
Rate for Payer: Priority Health Commercial	$47.59
Rate for Payer: Priority Health PPO	$47.59

YERSINIA CULTURE

Facility

$5.50

Hospital Charge Code	3102458
Hospital Revenue Code	300
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$4.67
Rate for Payer: Cash Price	$3.58
Rate for Payer: Community Health Alliance Commercial	$4.67
Rate for Payer: Priority Health Commercial	$3.85
Rate for Payer: Priority Health PPO	$3.85

ZARONTIN ETHOSUXOMIDE

Facility

$42.00

Service Code	HCPCS 80168
Hospital Charge Code	3004080
Hospital Revenue Code	301
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$35.70
Rate for Payer: BCBS BCN 65	$17.16
Rate for Payer: Blue Care Network Medicare Advantage	$17.16
Rate for Payer: Cash Price	$27.30
Rate for Payer: Cash Price	$27.30
Rate for Payer: Community Health Alliance Commercial	$35.70
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$17.16
Rate for Payer: Meridian Health Plan Medicare	$17.16
Rate for Payer: Priority Health Commercial	$29.40
Rate for Payer: Priority Health Medicaid	$17.16
Rate for Payer: Priority Health Medicare	$17.16
Rate for Payer: Priority Health PPO	$29.40
Rate for Payer: United Health Care Medicaid	$17.16
Rate for Payer: United Health Care Medicare Advantage	$7.55

Z CELIA PANEL

Facility

$27.22

Hospital Charge Code	3101479
Hospital Revenue Code	300
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$23.14
Rate for Payer: Cash Price	$17.69
Rate for Payer: Community Health Alliance Commercial	$23.14
Rate for Payer: Priority Health Commercial	$19.05
Rate for Payer: Priority Health PPO	$19.05

Z CELIAS HLA DQ ASSOCIATION

Facility

$112.40

Hospital Charge Code	3101655
Hospital Revenue Code	300
Min. Negotiated Rate	$78.68
Max. Negotiated Rate	$95.54
Rate for Payer: Cash Price	$73.06
Rate for Payer: Community Health Alliance Commercial	$95.54
Rate for Payer: Priority Health Commercial	$78.68
Rate for Payer: Priority Health PPO	$78.68

ZIKA (ONE ONLY)

Facility

$7.00

Hospital Charge Code	3101319
Hospital Revenue Code	300
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$5.95
Rate for Payer: Cash Price	$4.55
Rate for Payer: Community Health Alliance Commercial	$5.95
Rate for Payer: Priority Health Commercial	$4.90
Rate for Payer: Priority Health PPO	$4.90

ZIKA VIRUS AB IgM

Facility

$45.00

Hospital Charge Code	3101378
Hospital Revenue Code	300
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$38.25
Rate for Payer: Cash Price	$29.25
Rate for Payer: Community Health Alliance Commercial	$38.25
Rate for Payer: Priority Health Commercial	$31.50
Rate for Payer: Priority Health PPO	$31.50

ZINC

Facility

$4.28

Service Code	HCPCS 84630
Hospital Charge Code	3008960
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$11.96
Rate for Payer: BCBS BCN 65	$11.96
Rate for Payer: Blue Care Network Medicare Advantage	$11.96
Rate for Payer: Cash Price	$2.78
Rate for Payer: Cash Price	$2.78
Rate for Payer: Community Health Alliance Commercial	$3.64
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$11.96
Rate for Payer: Meridian Health Plan Medicare	$11.96
Rate for Payer: Priority Health Commercial	$3.00
Rate for Payer: Priority Health Medicaid	$11.96
Rate for Payer: Priority Health Medicare	$11.96
Rate for Payer: Priority Health PPO	$3.00
Rate for Payer: United Health Care Medicaid	$11.96
Rate for Payer: United Health Care Medicare Advantage	$5.26

ZINC RBC

Facility

$25.00

Hospital Charge Code	3101242
Hospital Revenue Code	301
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$21.25
Rate for Payer: Cash Price	$16.25
Rate for Payer: Community Health Alliance Commercial	$21.25
Rate for Payer: Priority Health Commercial	$17.50
Rate for Payer: Priority Health PPO	$17.50

ZINC TRANSPORTER AB

Facility

$82.00

Hospital Charge Code	3101317
Hospital Revenue Code	310
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$69.70
Rate for Payer: Cash Price	$53.30
Rate for Payer: Community Health Alliance Commercial	$69.70
Rate for Payer: Priority Health Commercial	$57.40
Rate for Payer: Priority Health PPO	$57.40

ZINC WHOLE BLOOD

Facility

$25.00

Hospital Charge Code	3101999
Hospital Revenue Code	300
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$21.25
Rate for Payer: Cash Price	$16.25
Rate for Payer: Community Health Alliance Commercial	$21.25
Rate for Payer: Priority Health Commercial	$17.50
Rate for Payer: Priority Health PPO	$17.50

ZIPRASIDONE

Facility

$107.00

Service Code	HCPCS G0480
Hospital Charge Code	3000414
Hospital Revenue Code	301
Min. Negotiated Rate	$52.87
Max. Negotiated Rate	$120.15
Rate for Payer: BCBS BCN 65	$120.15
Rate for Payer: Blue Care Network Medicare Advantage	$120.15
Rate for Payer: Cash Price	$69.55
Rate for Payer: Cash Price	$69.55
Rate for Payer: Community Health Alliance Commercial	$90.95
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$120.15
Rate for Payer: Meridian Health Plan Medicare	$120.15
Rate for Payer: Priority Health Commercial	$74.90
Rate for Payer: Priority Health Medicaid	$120.15
Rate for Payer: Priority Health Medicare	$120.15
Rate for Payer: Priority Health PPO	$74.90
Rate for Payer: United Health Care Medicaid	$120.15
Rate for Payer: United Health Care Medicare Advantage	$52.87

ZONISAMIDE

Facility

$62.00

Hospital Charge Code	3006985
Hospital Revenue Code	301
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

ZZ BILL ONLY CRYPTOCOCCAL AG T

Facility

$12.50

Hospital Charge Code	3101129
Hospital Revenue Code	306
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$10.62
Rate for Payer: Cash Price	$8.13
Rate for Payer: Community Health Alliance Commercial	$10.62
Rate for Payer: Priority Health Commercial	$8.75
Rate for Payer: Priority Health PPO	$8.75

ZZ BILL ONLY CRYTOCOCCAL AG TI

Facility

$10.60

Hospital Charge Code	3101169
Hospital Revenue Code	306
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$9.01
Rate for Payer: Cash Price	$6.89
Rate for Payer: Community Health Alliance Commercial	$9.01
Rate for Payer: Priority Health Commercial	$7.42
Rate for Payer: Priority Health PPO	$7.42

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges