Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

ACE TROCHANTERIC NAIL 180X11

Facility

$2,397.00

Service Code	HCPCS C1713
Hospital Charge Code	27872096
Hospital Revenue Code	278
Min. Negotiated Rate	$1,677.90
Max. Negotiated Rate	$2,037.45
Rate for Payer: Cash Price	$1,558.05
Rate for Payer: Community Health Alliance Commercial	$2,037.45
Rate for Payer: Priority Health Commercial	$1,677.90
Rate for Payer: Priority Health PPO	$1,677.90

ACE TROCHANTERIC NAIL END CAP

Facility

$419.00

Service Code	HCPCS C1713
Hospital Charge Code	27872104
Hospital Revenue Code	278
Min. Negotiated Rate	$293.30
Max. Negotiated Rate	$356.15
Rate for Payer: Cash Price	$272.35
Rate for Payer: Community Health Alliance Commercial	$356.15
Rate for Payer: Priority Health Commercial	$293.30
Rate for Payer: Priority Health PPO	$293.30

ACE TROCHANTERIC NAIL LAG SCRW

Facility

$708.00

Service Code	HCPCS C1713
Hospital Charge Code	27868894
Hospital Revenue Code	278
Min. Negotiated Rate	$495.60
Max. Negotiated Rate	$601.80
Rate for Payer: Cash Price	$460.20
Rate for Payer: Community Health Alliance Commercial	$601.80
Rate for Payer: Priority Health Commercial	$495.60
Rate for Payer: Priority Health PPO	$495.60

ACETYLCHOLINE RECEPTOR ANTI

Facility

$132.00

Service Code	HCPCS 84238
Hospital Charge Code	3000240
Hospital Revenue Code	301
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$112.20
Rate for Payer: BCBS BCN 65	$38.40
Rate for Payer: Blue Care Network Medicare Advantage	$38.40
Rate for Payer: Cash Price	$85.80
Rate for Payer: Cash Price	$85.80
Rate for Payer: Community Health Alliance Commercial	$112.20
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$38.40
Rate for Payer: Meridian Health Plan Medicare	$38.40
Rate for Payer: Priority Health Commercial	$92.40
Rate for Payer: Priority Health Medicaid	$38.40
Rate for Payer: Priority Health Medicare	$38.40
Rate for Payer: Priority Health PPO	$92.40
Rate for Payer: United Health Care Medicaid	$38.40
Rate for Payer: United Health Care Medicare Advantage	$16.90

ACETYLCHOLINESTERASE

Facility

$96.00

Service Code	HCPCS 82013
Hospital Charge Code	3001105
Hospital Revenue Code	301
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$81.60
Rate for Payer: BCBS BCN 65	$12.90
Rate for Payer: Blue Care Network Medicare Advantage	$12.90
Rate for Payer: Cash Price	$62.40
Rate for Payer: Cash Price	$62.40
Rate for Payer: Community Health Alliance Commercial	$81.60
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$12.90
Rate for Payer: Meridian Health Plan Medicare	$12.90
Rate for Payer: Priority Health Commercial	$67.20
Rate for Payer: Priority Health Medicaid	$12.90
Rate for Payer: Priority Health Medicare	$12.90
Rate for Payer: Priority Health PPO	$67.20
Rate for Payer: United Health Care Medicaid	$12.90
Rate for Payer: United Health Care Medicare Advantage	$5.68

ACETYL RECEPTOR BINDING AB

Facility

$11.40

Hospital Charge Code	3000210
Hospital Revenue Code	301
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$9.69
Rate for Payer: Cash Price	$7.41
Rate for Payer: Community Health Alliance Commercial	$9.69
Rate for Payer: Priority Health Commercial	$7.98
Rate for Payer: Priority Health PPO	$7.98

ACGS-1

Facility

$7.22

Hospital Charge Code	3102450
Hospital Revenue Code	306
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$6.14
Rate for Payer: Cash Price	$4.69
Rate for Payer: Community Health Alliance Commercial	$6.14
Rate for Payer: Priority Health Commercial	$5.05
Rate for Payer: Priority Health PPO	$5.05

ACGS-2

Facility

$7.23

Hospital Charge Code	3102451
Hospital Revenue Code	306
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$6.15
Rate for Payer: Cash Price	$4.70
Rate for Payer: Community Health Alliance Commercial	$6.15
Rate for Payer: Priority Health Commercial	$5.06
Rate for Payer: Priority Health PPO	$5.06

ACHR BIND RFX MUSK-LC

Facility

$11.40

Hospital Charge Code	31027385
Hospital Revenue Code	300
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$9.69
Rate for Payer: Cash Price	$7.41
Rate for Payer: Community Health Alliance Commercial	$9.69
Rate for Payer: Priority Health Commercial	$7.98
Rate for Payer: Priority Health PPO	$7.98

AChR MODULATING AB

Facility

$89.00

Hospital Charge Code	3100058
Hospital Revenue Code	300
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$75.65
Rate for Payer: Cash Price	$57.85
Rate for Payer: Community Health Alliance Commercial	$75.65
Rate for Payer: Priority Health Commercial	$62.30
Rate for Payer: Priority Health PPO	$62.30

ACHR/MUSK-LC 1

Facility

$35.52

Hospital Charge Code	31027387
Hospital Revenue Code	300
Min. Negotiated Rate	$24.86
Max. Negotiated Rate	$30.19
Rate for Payer: Cash Price	$23.09
Rate for Payer: Community Health Alliance Commercial	$30.19
Rate for Payer: Priority Health Commercial	$24.86
Rate for Payer: Priority Health PPO	$24.86

ACHR/MUSK-LC 2

Facility

$35.52

Hospital Charge Code	31027388
Hospital Revenue Code	300
Min. Negotiated Rate	$24.86
Max. Negotiated Rate	$30.19
Rate for Payer: Cash Price	$23.09
Rate for Payer: Community Health Alliance Commercial	$30.19
Rate for Payer: Priority Health Commercial	$24.86
Rate for Payer: Priority Health PPO	$24.86

ACHR/MUSK-LC 3

Facility

$35.52

Hospital Charge Code	31027389
Hospital Revenue Code	300
Min. Negotiated Rate	$24.86
Max. Negotiated Rate	$30.19
Rate for Payer: Cash Price	$23.09
Rate for Payer: Community Health Alliance Commercial	$30.19
Rate for Payer: Priority Health Commercial	$24.86
Rate for Payer: Priority Health PPO	$24.86

ACHR RECEPTOR AB RFX MUSK

Facility

$106.56

Hospital Charge Code	31027386
Hospital Revenue Code	300
Min. Negotiated Rate	$74.59
Max. Negotiated Rate	$90.58
Rate for Payer: Cash Price	$69.26
Rate for Payer: Community Health Alliance Commercial	$90.58
Rate for Payer: Priority Health Commercial	$74.59
Rate for Payer: Priority Health PPO	$74.59

ACID FAST SMEAR

Facility

$7.00

Service Code	HCPCS 87206
Hospital Charge Code	3100005
Hospital Revenue Code	306
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$5.95
Rate for Payer: BCBS BCN 65	$5.66
Rate for Payer: Blue Care Network Medicare Advantage	$5.66
Rate for Payer: Cash Price	$4.55
Rate for Payer: Cash Price	$4.55
Rate for Payer: Community Health Alliance Commercial	$5.95
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$5.66
Rate for Payer: Meridian Health Plan Medicare	$5.66
Rate for Payer: Priority Health Commercial	$4.90
Rate for Payer: Priority Health Medicaid	$5.66
Rate for Payer: Priority Health Medicare	$5.66
Rate for Payer: Priority Health PPO	$4.90
Rate for Payer: United Health Care Medicaid	$5.66
Rate for Payer: United Health Care Medicare Advantage	$2.49

ACID FAST STAIN TECH

Facility

$87.00

Service Code	HCPCS 88312
Hospital Charge Code	3100010
Hospital Revenue Code	310
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$73.95
Rate for Payer: BCBS BCN 65	$55.90
Rate for Payer: Blue Care Network Medicare Advantage	$55.90
Rate for Payer: Cash Price	$56.55
Rate for Payer: Cash Price	$56.55
Rate for Payer: Community Health Alliance Commercial	$73.95
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$55.90
Rate for Payer: Meridian Health Plan Medicare	$55.90
Rate for Payer: Priority Health Commercial	$60.90
Rate for Payer: Priority Health Medicaid	$55.90
Rate for Payer: Priority Health Medicare	$55.90
Rate for Payer: Priority Health PPO	$60.90
Rate for Payer: United Health Care Medicaid	$55.90
Rate for Payer: United Health Care Medicare Advantage	$24.60

ACID PHOS, TOTAL

Facility

$5.70

Service Code	HCPCS 84066
Hospital Charge Code	3000260
Hospital Revenue Code	301
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$10.14
Rate for Payer: BCBS BCN 65	$10.14
Rate for Payer: Blue Care Network Medicare Advantage	$10.14
Rate for Payer: Cash Price	$3.71
Rate for Payer: Cash Price	$3.71
Rate for Payer: Community Health Alliance Commercial	$4.84
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$10.14
Rate for Payer: Meridian Health Plan Medicare	$10.14
Rate for Payer: Priority Health Commercial	$3.99
Rate for Payer: Priority Health Medicaid	$10.14
Rate for Payer: Priority Health Medicare	$10.14
Rate for Payer: Priority Health PPO	$3.99
Rate for Payer: United Health Care Medicaid	$10.14
Rate for Payer: United Health Care Medicare Advantage	$4.46

AC MODULATING ANTIBODY

Facility

$65.16

Service Code	HCPCS 86255
Hospital Charge Code	3000272
Hospital Revenue Code	301
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$55.39
Rate for Payer: BCBS BCN 65	$12.65
Rate for Payer: Blue Care Network Medicare Advantage	$12.65
Rate for Payer: Cash Price	$42.35
Rate for Payer: Cash Price	$42.35
Rate for Payer: Community Health Alliance Commercial	$55.39
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$12.65
Rate for Payer: Meridian Health Plan Medicare	$12.65
Rate for Payer: Priority Health Commercial	$45.61
Rate for Payer: Priority Health Medicaid	$12.65
Rate for Payer: Priority Health Medicare	$12.65
Rate for Payer: Priority Health PPO	$45.61
Rate for Payer: United Health Care Medicaid	$12.65
Rate for Payer: United Health Care Medicare Advantage	$5.57

ACTH

Facility

$5.75

Service Code	HCPCS 82024
Hospital Charge Code	3000280
Hospital Revenue Code	301
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$40.55
Rate for Payer: BCBS BCN 65	$40.55
Rate for Payer: Blue Care Network Medicare Advantage	$40.55
Rate for Payer: Cash Price	$3.74
Rate for Payer: Cash Price	$3.74
Rate for Payer: Community Health Alliance Commercial	$4.89
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$40.55
Rate for Payer: Meridian Health Plan Medicare	$40.55
Rate for Payer: Priority Health Commercial	$4.03
Rate for Payer: Priority Health Medicaid	$40.55
Rate for Payer: Priority Health Medicare	$40.55
Rate for Payer: Priority Health PPO	$4.03
Rate for Payer: United Health Care Medicaid	$40.55
Rate for Payer: United Health Care Medicare Advantage	$17.84

ACTH3-1

Facility

$5.75

Hospital Charge Code	3000417
Hospital Revenue Code	300
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.89
Rate for Payer: Cash Price	$3.74
Rate for Payer: Community Health Alliance Commercial	$4.89
Rate for Payer: Priority Health Commercial	$4.03
Rate for Payer: Priority Health PPO	$4.03

ACTH3-2

Facility

$5.75

Hospital Charge Code	3000418
Hospital Revenue Code	300
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.89
Rate for Payer: Cash Price	$3.74
Rate for Payer: Community Health Alliance Commercial	$4.89
Rate for Payer: Priority Health Commercial	$4.03
Rate for Payer: Priority Health PPO	$4.03

ACTH3-3

Facility

$5.75

Hospital Charge Code	3102204
Hospital Revenue Code	300
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.89
Rate for Payer: Cash Price	$3.74
Rate for Payer: Community Health Alliance Commercial	$4.89
Rate for Payer: Priority Health Commercial	$4.03
Rate for Payer: Priority Health PPO	$4.03

ACTH4-1

Facility

$12.14

Hospital Charge Code	3000416
Hospital Revenue Code	300
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$10.32
Rate for Payer: Cash Price	$7.89
Rate for Payer: Community Health Alliance Commercial	$10.32
Rate for Payer: Priority Health Commercial	$8.50
Rate for Payer: Priority Health PPO	$8.50

ACTH4-2

Facility

$12.14

Hospital Charge Code	3102205
Hospital Revenue Code	300
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$10.32
Rate for Payer: Cash Price	$7.89
Rate for Payer: Community Health Alliance Commercial	$10.32
Rate for Payer: Priority Health Commercial	$8.50
Rate for Payer: Priority Health PPO	$8.50

ACTH4-3

Facility

$12.14

Hospital Charge Code	3102206
Hospital Revenue Code	300
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$10.32
Rate for Payer: Cash Price	$7.89
Rate for Payer: Community Health Alliance Commercial	$10.32
Rate for Payer: Priority Health Commercial	$8.50
Rate for Payer: Priority Health PPO	$8.50

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges