Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

CHOLESTEROL SELF ORDERED

Facility

$18.00

Service Code	HCPCS 82465
Hospital Charge Code	3002281
Hospital Revenue Code	301
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$15.30
Rate for Payer: BCBS BCN 65	$4.57
Rate for Payer: Blue Care Network Medicare Advantage	$4.57
Rate for Payer: Cash Price	$11.70
Rate for Payer: Cash Price	$11.70
Rate for Payer: Community Health Alliance Commercial	$15.30
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$4.57
Rate for Payer: Meridian Health Plan Medicare	$4.57
Rate for Payer: Priority Health Commercial	$12.60
Rate for Payer: Priority Health Medicaid	$4.57
Rate for Payer: Priority Health Medicare	$4.57
Rate for Payer: Priority Health PPO	$12.60
Rate for Payer: United Health Care Medicaid	$4.57
Rate for Payer: United Health Care Medicare Advantage	$2.01

CHOLINESTERASE-RBC

Facility

$43.00

Service Code	HCPCS 82482
Hospital Charge Code	3003080
Hospital Revenue Code	301
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$36.55
Rate for Payer: BCBS BCN 65	$10.30
Rate for Payer: Blue Care Network Medicare Advantage	$10.30
Rate for Payer: Cash Price	$27.95
Rate for Payer: Cash Price	$27.95
Rate for Payer: Community Health Alliance Commercial	$36.55
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$10.30
Rate for Payer: Meridian Health Plan Medicare	$10.30
Rate for Payer: Priority Health Commercial	$30.10
Rate for Payer: Priority Health Medicaid	$10.30
Rate for Payer: Priority Health Medicare	$10.30
Rate for Payer: Priority Health PPO	$30.10
Rate for Payer: United Health Care Medicaid	$10.30
Rate for Payer: United Health Care Medicare Advantage	$4.53

CHOLINESTERASE SERUM

Facility

$2.66

Service Code	HCPCS 82480
Hospital Charge Code	3003060
Hospital Revenue Code	301
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$8.26
Rate for Payer: BCBS BCN 65	$8.26
Rate for Payer: Blue Care Network Medicare Advantage	$8.26
Rate for Payer: Cash Price	$1.73
Rate for Payer: Cash Price	$1.73
Rate for Payer: Community Health Alliance Commercial	$2.26
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.26
Rate for Payer: Meridian Health Plan Medicare	$8.26
Rate for Payer: Priority Health Commercial	$1.86
Rate for Payer: Priority Health Medicaid	$8.26
Rate for Payer: Priority Health Medicare	$8.26
Rate for Payer: Priority Health PPO	$1.86
Rate for Payer: United Health Care Medicaid	$8.26
Rate for Payer: United Health Care Medicare Advantage	$3.64

CHROM ANALY 5 CELLS

Facility

$259.00

Hospital Charge Code	3101027
Hospital Revenue Code	310
Min. Negotiated Rate	$181.30
Max. Negotiated Rate	$220.15
Rate for Payer: Cash Price	$168.35
Rate for Payer: Community Health Alliance Commercial	$220.15
Rate for Payer: Priority Health Commercial	$181.30
Rate for Payer: Priority Health PPO	$181.30

CHROM ANALY ADDTL CELL COUNTS

Facility

$8.00

Hospital Charge Code	3101028
Hospital Revenue Code	310
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$6.80
Rate for Payer: Cash Price	$5.20
Rate for Payer: Community Health Alliance Commercial	$6.80
Rate for Payer: Priority Health Commercial	$5.60
Rate for Payer: Priority Health PPO	$5.60

CHROM ANALY ADDTL KARYOT EA

Facility

$27.00

Hospital Charge Code	3101030
Hospital Revenue Code	310
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$22.95
Rate for Payer: Cash Price	$17.55
Rate for Payer: Community Health Alliance Commercial	$22.95
Rate for Payer: Priority Health Commercial	$18.90
Rate for Payer: Priority Health PPO	$18.90

CHROM ANALYSIS 20-25 CELLS

Facility

$287.00

Hospital Charge Code	3100544
Hospital Revenue Code	311
Min. Negotiated Rate	$200.90
Max. Negotiated Rate	$243.95
Rate for Payer: Cash Price	$186.55
Rate for Payer: Community Health Alliance Commercial	$243.95
Rate for Payer: Priority Health Commercial	$200.90
Rate for Payer: Priority Health PPO	$200.90

CHROMATIN IGG ANTIBODY

Facility

$15.00

Hospital Charge Code	3100015
Hospital Revenue Code	302
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$12.75
Rate for Payer: Cash Price	$9.75
Rate for Payer: Community Health Alliance Commercial	$12.75
Rate for Payer: Priority Health Commercial	$10.50
Rate for Payer: Priority Health PPO	$10.50

CHROMIUM

Facility

$6.00

Service Code	HCPCS 82495
Hospital Charge Code	3002290
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$21.29
Rate for Payer: BCBS BCN 65	$21.29
Rate for Payer: Blue Care Network Medicare Advantage	$21.29
Rate for Payer: Cash Price	$3.90
Rate for Payer: Cash Price	$3.90
Rate for Payer: Community Health Alliance Commercial	$5.10
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$21.29
Rate for Payer: Meridian Health Plan Medicare	$21.29
Rate for Payer: Priority Health Commercial	$4.20
Rate for Payer: Priority Health Medicaid	$21.29
Rate for Payer: Priority Health Medicare	$21.29
Rate for Payer: Priority Health PPO	$4.20
Rate for Payer: United Health Care Medicaid	$21.29
Rate for Payer: United Health Care Medicare Advantage	$9.37

CHROMIUM WHOLE BLOOD

Facility

$36.26

Hospital Charge Code	3101325
Hospital Revenue Code	301
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$30.82
Rate for Payer: Cash Price	$23.57
Rate for Payer: Community Health Alliance Commercial	$30.82
Rate for Payer: Priority Health Commercial	$25.38
Rate for Payer: Priority Health PPO	$25.38

CHROMOGRANIN-A

Facility

$28.00

Service Code	HCPCS 86316
Hospital Charge Code	3001910
Hospital Revenue Code	302
Min. Negotiated Rate	$9.61
Max. Negotiated Rate	$23.80
Rate for Payer: BCBS BCN 65	$21.85
Rate for Payer: Blue Care Network Medicare Advantage	$21.85
Rate for Payer: Cash Price	$18.20
Rate for Payer: Cash Price	$18.20
Rate for Payer: Community Health Alliance Commercial	$23.80
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$21.85
Rate for Payer: Meridian Health Plan Medicare	$21.85
Rate for Payer: Priority Health Commercial	$19.60
Rate for Payer: Priority Health Medicaid	$21.85
Rate for Payer: Priority Health Medicare	$21.85
Rate for Payer: Priority Health PPO	$19.60
Rate for Payer: United Health Care Medicaid	$21.85
Rate for Payer: United Health Care Medicare Advantage	$9.61

CHROMOSOMAS MICROARRAY ANALYSI

Facility

$890.00

Hospital Charge Code	3101408
Hospital Revenue Code	300
Min. Negotiated Rate	$623.00
Max. Negotiated Rate	$756.50
Rate for Payer: Cash Price	$578.50
Rate for Payer: Community Health Alliance Commercial	$756.50
Rate for Payer: Priority Health Commercial	$623.00
Rate for Payer: Priority Health PPO	$623.00

CHROMOSOME ANALYSIS BLOOK

Facility

$1,422.00

Hospital Charge Code	3000616
Hospital Revenue Code	311
Min. Negotiated Rate	$995.40
Max. Negotiated Rate	$1,208.70
Rate for Payer: Cash Price	$924.30
Rate for Payer: Community Health Alliance Commercial	$1,208.70
Rate for Payer: Priority Health Commercial	$995.40
Rate for Payer: Priority Health PPO	$995.40

CHROMOSOME ANALYSIS,CT/KT/BAND

Facility

$383.00

Service Code	HCPCS 88262
Hospital Charge Code	3005492
Hospital Revenue Code	310
Min. Negotiated Rate	$57.98
Max. Negotiated Rate	$325.55
Rate for Payer: BCBS BCN 65	$131.76
Rate for Payer: Blue Care Network Medicare Advantage	$131.76
Rate for Payer: Cash Price	$248.95
Rate for Payer: Cash Price	$248.95
Rate for Payer: Community Health Alliance Commercial	$325.55
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$131.76
Rate for Payer: Meridian Health Plan Medicare	$131.76
Rate for Payer: Priority Health Commercial	$268.10
Rate for Payer: Priority Health Medicaid	$131.76
Rate for Payer: Priority Health Medicare	$131.76
Rate for Payer: Priority Health PPO	$268.10
Rate for Payer: United Health Care Medicaid	$131.76
Rate for Payer: United Health Care Medicare Advantage	$57.98

CHROMOSOME BLOOD ROUTINE

Facility

$106.45

Hospital Charge Code	3102496
Hospital Revenue Code	300
Min. Negotiated Rate	$74.52
Max. Negotiated Rate	$90.48
Rate for Payer: Cash Price	$69.19
Rate for Payer: Community Health Alliance Commercial	$90.48
Rate for Payer: Priority Health Commercial	$74.52
Rate for Payer: Priority Health PPO	$74.52

CHROMOSOME MICROARRAY ADULT

Facility

$1,433.11

Hospital Charge Code	3102515
Hospital Revenue Code	300
Min. Negotiated Rate	$1,003.18
Max. Negotiated Rate	$1,218.14
Rate for Payer: Cash Price	$931.52
Rate for Payer: Community Health Alliance Commercial	$1,218.14
Rate for Payer: Priority Health Commercial	$1,003.18
Rate for Payer: Priority Health PPO	$1,003.18

CHROMOSONE ANALYSIS AMN FLUID

Facility

$990.00

Hospital Charge Code	3007713
Hospital Revenue Code	311
Min. Negotiated Rate	$693.00
Max. Negotiated Rate	$841.50
Rate for Payer: Cash Price	$643.50
Rate for Payer: Community Health Alliance Commercial	$841.50
Rate for Payer: Priority Health Commercial	$693.00
Rate for Payer: Priority Health PPO	$693.00

CHROMSOME ANALYSIS AMNIOTIC FL

Facility

$1,242.00

Hospital Charge Code	3000713
Hospital Revenue Code	311
Min. Negotiated Rate	$869.40
Max. Negotiated Rate	$1,055.70
Rate for Payer: Cash Price	$807.30
Rate for Payer: Community Health Alliance Commercial	$1,055.70
Rate for Payer: Priority Health Commercial	$869.40
Rate for Payer: Priority Health PPO	$869.40

CHRONIC URTICARIA INDEX

Facility

$80.00

Hospital Charge Code	3100519
Hospital Revenue Code	309
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$68.00
Rate for Payer: Cash Price	$52.00
Rate for Payer: Community Health Alliance Commercial	$68.00
Rate for Payer: Priority Health Commercial	$56.00
Rate for Payer: Priority Health PPO	$56.00

CIQ BINDING ASSAY

Facility

$400.00

Hospital Charge Code	3102678
Hospital Revenue Code	300
Min. Negotiated Rate	$280.00
Max. Negotiated Rate	$340.00
Rate for Payer: Cash Price	$260.00
Rate for Payer: Community Health Alliance Commercial	$340.00
Rate for Payer: Priority Health Commercial	$280.00
Rate for Payer: Priority Health PPO	$280.00

CIRCULATING TUMOR CELL COUNT

Facility

$297.50

Hospital Charge Code	3100731
Hospital Revenue Code	309
Min. Negotiated Rate	$208.25
Max. Negotiated Rate	$252.88
Rate for Payer: Cash Price	$193.38
Rate for Payer: Community Health Alliance Commercial	$252.88
Rate for Payer: Priority Health Commercial	$208.25
Rate for Payer: Priority Health PPO	$208.25

CITRIC ACID URINE

Facility

$10.00

Service Code	HCPCS 82507
Hospital Charge Code	3003120
Hospital Revenue Code	301
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$29.19
Rate for Payer: BCBS BCN 65	$29.19
Rate for Payer: Blue Care Network Medicare Advantage	$29.19
Rate for Payer: Cash Price	$6.50
Rate for Payer: Cash Price	$6.50
Rate for Payer: Community Health Alliance Commercial	$8.50
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$29.19
Rate for Payer: Meridian Health Plan Medicare	$29.19
Rate for Payer: Priority Health Commercial	$7.00
Rate for Payer: Priority Health Medicaid	$29.19
Rate for Payer: Priority Health Medicare	$29.19
Rate for Payer: Priority Health PPO	$7.00
Rate for Payer: United Health Care Medicaid	$29.19
Rate for Payer: United Health Care Medicare Advantage	$12.84

CITY OF STURGIS HEALTH ASSESS

Facility

$119.00

Hospital Charge Code	3000063
Hospital Revenue Code	309
Min. Negotiated Rate	$83.30
Max. Negotiated Rate	$101.15
Rate for Payer: Cash Price	$77.35
Rate for Payer: Community Health Alliance Commercial	$101.15
Rate for Payer: Priority Health Commercial	$83.30
Rate for Payer: Priority Health PPO	$83.30

CJAK2 REFLEX

Facility

$107.92

Hospital Charge Code	3102540
Hospital Revenue Code	300
Min. Negotiated Rate	$75.54
Max. Negotiated Rate	$91.73
Rate for Payer: Cash Price	$70.15
Rate for Payer: Community Health Alliance Commercial	$91.73
Rate for Payer: Priority Health Commercial	$75.54
Rate for Payer: Priority Health PPO	$75.54

CKI-1

Facility

$2.82

Hospital Charge Code	3101814
Hospital Revenue Code	300
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$2.40
Rate for Payer: Cash Price	$1.83
Rate for Payer: Community Health Alliance Commercial	$2.40
Rate for Payer: Priority Health Commercial	$1.97
Rate for Payer: Priority Health PPO	$1.97

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges