Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

CATECHOLAMINES,SE

Facility

$20.36

Service Code	HCPCS 82383
Hospital Charge Code	3003341
Hospital Revenue Code	301
Min. Negotiated Rate	$13.43
Max. Negotiated Rate	$30.53
Rate for Payer: BCBS BCN 65	$30.53
Rate for Payer: Blue Care Network Medicare Advantage	$30.53
Rate for Payer: Cash Price	$13.23
Rate for Payer: Cash Price	$13.23
Rate for Payer: Community Health Alliance Commercial	$17.31
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$30.53
Rate for Payer: Meridian Health Plan Medicare	$30.53
Rate for Payer: Priority Health Commercial	$14.25
Rate for Payer: Priority Health Medicaid	$30.53
Rate for Payer: Priority Health Medicare	$30.53
Rate for Payer: Priority Health PPO	$14.25
Rate for Payer: United Health Care Medicaid	$30.53
Rate for Payer: United Health Care Medicare Advantage	$13.43

CATECHOLAMINES URINE

Facility

$19.76

Hospital Charge Code	3102111
Hospital Revenue Code	300
Min. Negotiated Rate	$13.83
Max. Negotiated Rate	$16.80
Rate for Payer: Cash Price	$12.84
Rate for Payer: Community Health Alliance Commercial	$16.80
Rate for Payer: Priority Health Commercial	$13.83
Rate for Payer: Priority Health PPO	$13.83

CATHETER, 20 BAND PIG

Facility

$264.00

Hospital Charge Code	27268449
Hospital Revenue Code	272
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$224.40
Rate for Payer: Cash Price	$171.60
Rate for Payer: Community Health Alliance Commercial	$224.40
Rate for Payer: Priority Health Commercial	$184.80
Rate for Payer: Priority Health PPO	$184.80

CATHETER,ALL PURPOSE DRAINAGE

Facility

$1,013.00

Service Code	HCPCS C1729
Hospital Charge Code	27266781
Hospital Revenue Code	272
Min. Negotiated Rate	$709.10
Max. Negotiated Rate	$861.05
Rate for Payer: Cash Price	$658.45
Rate for Payer: Community Health Alliance Commercial	$861.05
Rate for Payer: Priority Health Commercial	$709.10
Rate for Payer: Priority Health PPO	$709.10

CATHETER, ANGIO BEACON TIP

Facility

$75.00

Hospital Charge Code	27264389
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$63.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Community Health Alliance Commercial	$63.75
Rate for Payer: Priority Health Commercial	$52.50
Rate for Payer: Priority Health PPO	$52.50

CATHETER, ANGIOPLASTY

Facility

$478.00

Service Code	HCPCS C1725
Hospital Charge Code	62115669
Hospital Revenue Code	272
Min. Negotiated Rate	$334.60
Max. Negotiated Rate	$406.30
Rate for Payer: Cash Price	$310.70
Rate for Payer: Community Health Alliance Commercial	$406.30
Rate for Payer: Priority Health Commercial	$334.60
Rate for Payer: Priority Health PPO	$334.60

CATHETER, ANGIOPLASTY TRANSLUM

Facility

$774.00

Service Code	HCPCS C1725
Hospital Charge Code	27014472
Hospital Revenue Code	272
Min. Negotiated Rate	$541.80
Max. Negotiated Rate	$657.90
Rate for Payer: Cash Price	$503.10
Rate for Payer: Community Health Alliance Commercial	$657.90
Rate for Payer: Priority Health Commercial	$541.80
Rate for Payer: Priority Health PPO	$541.80

CATHETER, ANGIO TENNIS RAQUET

Facility

$87.00

Hospital Charge Code	27014407
Hospital Revenue Code	272
Min. Negotiated Rate	$60.90
Max. Negotiated Rate	$73.95
Rate for Payer: Cash Price	$56.55
Rate for Payer: Community Health Alliance Commercial	$73.95
Rate for Payer: Priority Health Commercial	$60.90
Rate for Payer: Priority Health PPO	$60.90

CATHETER,ARTERIAL EMB FOGARTY

Facility

$224.00

Service Code	HCPCS C1757
Hospital Charge Code	27021857
Hospital Revenue Code	272
Min. Negotiated Rate	$156.80
Max. Negotiated Rate	$190.40
Rate for Payer: Cash Price	$145.60
Rate for Payer: Community Health Alliance Commercial	$190.40
Rate for Payer: Priority Health Commercial	$156.80
Rate for Payer: Priority Health PPO	$156.80

CATHETER,BALLON DILATATION

Facility

$688.00

Service Code	HCPCS C1726
Hospital Charge Code	27263524
Hospital Revenue Code	272
Min. Negotiated Rate	$481.60
Max. Negotiated Rate	$584.80
Rate for Payer: Cash Price	$447.20
Rate for Payer: Community Health Alliance Commercial	$584.80
Rate for Payer: Priority Health Commercial	$481.60
Rate for Payer: Priority Health PPO	$481.60

CATHETER, BALLOON DILATION

Facility

$1,147.00

Service Code	HCPCS C1725
Hospital Charge Code	27014696
Hospital Revenue Code	272
Min. Negotiated Rate	$802.90
Max. Negotiated Rate	$974.95
Rate for Payer: Cash Price	$745.55
Rate for Payer: Community Health Alliance Commercial	$974.95
Rate for Payer: Priority Health Commercial	$802.90
Rate for Payer: Priority Health PPO	$802.90

CATHETER,BALLOON DILATOR,PYLOR

Facility

$411.00

Service Code	HCPCS C1726
Hospital Charge Code	27262464
Hospital Revenue Code	272
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$349.35
Rate for Payer: Cash Price	$267.15
Rate for Payer: Community Health Alliance Commercial	$349.35
Rate for Payer: Priority Health Commercial	$287.70
Rate for Payer: Priority Health PPO	$287.70

CATHETER,BALLOON EXTRACTION

Facility

$514.00

Hospital Charge Code	27019281
Hospital Revenue Code	272
Min. Negotiated Rate	$359.80
Max. Negotiated Rate	$436.90
Rate for Payer: Cash Price	$334.10
Rate for Payer: Community Health Alliance Commercial	$436.90
Rate for Payer: Priority Health Commercial	$359.80
Rate for Payer: Priority Health PPO	$359.80

CATHETER, BALLOON RETRIEVAL

Facility

$550.00

Service Code	HCPCS C1773
Hospital Charge Code	27021022
Hospital Revenue Code	272
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$467.50
Rate for Payer: Cash Price	$357.50
Rate for Payer: Community Health Alliance Commercial	$467.50
Rate for Payer: Priority Health Commercial	$385.00
Rate for Payer: Priority Health PPO	$385.00

CATHETER, BILIARY DILATION

Facility

$300.00

Service Code	HCPCS C1725
Hospital Charge Code	27262080
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$255.00
Rate for Payer: Cash Price	$195.00
Rate for Payer: Community Health Alliance Commercial	$255.00
Rate for Payer: Priority Health Commercial	$210.00
Rate for Payer: Priority Health PPO	$210.00

CATHETER,CONE TIP URETERAL10FR

Facility

$47.00

Service Code	HCPCS C1758
Hospital Charge Code	27022541
Hospital Revenue Code	272
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$39.95
Rate for Payer: Cash Price	$30.55
Rate for Payer: Community Health Alliance Commercial	$39.95
Rate for Payer: Priority Health Commercial	$32.90
Rate for Payer: Priority Health PPO	$32.90

CATHETER COUDE TIP

Facility

$12.15

Hospital Charge Code	27277913
Hospital Revenue Code	272
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$10.33
Rate for Payer: Cash Price	$7.90
Rate for Payer: Community Health Alliance Commercial	$10.33
Rate for Payer: Priority Health Commercial	$8.51
Rate for Payer: Priority Health PPO	$8.51

CATHETER-CUTDOWN

Facility

$18.00

Hospital Charge Code	27012419
Hospital Revenue Code	272
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

CATHETER,ENDOPYELOTOMY/ENDO

Facility

$7,004.00

Hospital Charge Code	27022921
Hospital Revenue Code	272
Min. Negotiated Rate	$4,902.80
Max. Negotiated Rate	$5,953.40
Rate for Payer: Cash Price	$4,552.60
Rate for Payer: Community Health Alliance Commercial	$5,953.40
Rate for Payer: Priority Health Commercial	$4,902.80
Rate for Payer: Priority Health PPO	$4,902.80

CATHETER, ENTEROCLYSIS

Facility

$446.00

Hospital Charge Code	27262663
Hospital Revenue Code	272
Min. Negotiated Rate	$312.20
Max. Negotiated Rate	$379.10
Rate for Payer: Cash Price	$289.90
Rate for Payer: Community Health Alliance Commercial	$379.10
Rate for Payer: Priority Health Commercial	$312.20
Rate for Payer: Priority Health PPO	$312.20

CATHETER,ENTEROCLYSIS

Facility

$651.00

Hospital Charge Code	27263378
Hospital Revenue Code	272
Min. Negotiated Rate	$455.70
Max. Negotiated Rate	$553.35
Rate for Payer: Cash Price	$423.15
Rate for Payer: Community Health Alliance Commercial	$553.35
Rate for Payer: Priority Health Commercial	$455.70
Rate for Payer: Priority Health PPO	$455.70

CATHETER, EPISTAXIS

Facility

$217.00

Hospital Charge Code	27061626
Hospital Revenue Code	272
Min. Negotiated Rate	$151.90
Max. Negotiated Rate	$184.45
Rate for Payer: Cash Price	$141.05
Rate for Payer: Community Health Alliance Commercial	$184.45
Rate for Payer: Priority Health Commercial	$151.90
Rate for Payer: Priority Health PPO	$151.90

CATHETER, ERCP BALL TIP

Facility

$165.00

Hospital Charge Code	27262945
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$140.25
Rate for Payer: Cash Price	$107.25
Rate for Payer: Community Health Alliance Commercial	$140.25
Rate for Payer: Priority Health Commercial	$115.50
Rate for Payer: Priority Health PPO	$115.50

CATHETER,FLUSH

Facility

$83.00

Hospital Charge Code	27263341
Hospital Revenue Code	272
Min. Negotiated Rate	$58.10
Max. Negotiated Rate	$70.55
Rate for Payer: Cash Price	$53.95
Rate for Payer: Community Health Alliance Commercial	$70.55
Rate for Payer: Priority Health Commercial	$58.10
Rate for Payer: Priority Health PPO	$58.10

CATHETER-FOLEY

Facility

$67.00

Hospital Charge Code	27013680
Hospital Revenue Code	272
Min. Negotiated Rate	$46.90
Max. Negotiated Rate	$56.95
Rate for Payer: Cash Price	$43.55
Rate for Payer: Community Health Alliance Commercial	$56.95
Rate for Payer: Priority Health Commercial	$46.90
Rate for Payer: Priority Health PPO	$46.90

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges