Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

ALA-1

Facility

$99.12

Hospital Charge Code	3102435
Hospital Revenue Code	300
Min. Negotiated Rate	$69.38
Max. Negotiated Rate	$84.25
Rate for Payer: Cash Price	$64.43
Rate for Payer: Community Health Alliance Commercial	$84.25
Rate for Payer: Priority Health Commercial	$69.38
Rate for Payer: Priority Health PPO	$69.38

ALA-2

Facility

$99.13

Hospital Charge Code	3102436
Hospital Revenue Code	300
Min. Negotiated Rate	$69.39
Max. Negotiated Rate	$84.26
Rate for Payer: Cash Price	$64.43
Rate for Payer: Community Health Alliance Commercial	$84.26
Rate for Payer: Priority Health Commercial	$69.39
Rate for Payer: Priority Health PPO	$69.39

ALA AMINOLEVLINIC ACID

Facility

$26.23

Service Code	HCPCS 82135
Hospital Charge Code	3000221
Hospital Revenue Code	301
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$22.30
Rate for Payer: BCBS BCN 65	$17.27
Rate for Payer: Blue Care Network Medicare Advantage	$17.27
Rate for Payer: Cash Price	$17.05
Rate for Payer: Cash Price	$17.05
Rate for Payer: Community Health Alliance Commercial	$22.30
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$17.27
Rate for Payer: Meridian Health Plan Medicare	$17.27
Rate for Payer: Priority Health Commercial	$18.36
Rate for Payer: Priority Health Medicaid	$17.27
Rate for Payer: Priority Health Medicare	$17.27
Rate for Payer: Priority Health PPO	$18.36
Rate for Payer: United Health Care Medicaid	$17.27
Rate for Payer: United Health Care Medicare Advantage	$7.60

ALA DEHYDROGENASE WB

Facility

$394.80

Hospital Charge Code	3102114
Hospital Revenue Code	300
Min. Negotiated Rate	$276.36
Max. Negotiated Rate	$335.58
Rate for Payer: Cash Price	$256.62
Rate for Payer: Community Health Alliance Commercial	$335.58
Rate for Payer: Priority Health Commercial	$276.36
Rate for Payer: Priority Health PPO	$276.36

ALBALTOR,TRIDENT 4.2 RESECTION

Facility

$684.00

Hospital Charge Code	27266609
Hospital Revenue Code	272
Min. Negotiated Rate	$478.80
Max. Negotiated Rate	$581.40
Rate for Payer: Cash Price	$444.60
Rate for Payer: Community Health Alliance Commercial	$581.40
Rate for Payer: Priority Health Commercial	$478.80
Rate for Payer: Priority Health PPO	$478.80

ALBUMIN

Facility

$2.60

Service Code	HCPCS 82042
Hospital Charge Code	3000300
Hospital Revenue Code	301
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$8.17
Rate for Payer: BCBS BCN 65	$8.17
Rate for Payer: Blue Care Network Medicare Advantage	$8.17
Rate for Payer: Cash Price	$1.69
Rate for Payer: Cash Price	$1.69
Rate for Payer: Community Health Alliance Commercial	$2.21
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.17
Rate for Payer: Meridian Health Plan Medicare	$8.17
Rate for Payer: Priority Health Commercial	$1.82
Rate for Payer: Priority Health Medicaid	$8.17
Rate for Payer: Priority Health Medicare	$8.17
Rate for Payer: Priority Health PPO	$1.82
Rate for Payer: United Health Care Medicaid	$8.17
Rate for Payer: United Health Care Medicare Advantage	$3.59

ALBUMIN

Facility

$1.25

Hospital Charge Code	3101474
Hospital Revenue Code	300
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$1.06
Rate for Payer: Cash Price	$0.81
Rate for Payer: Community Health Alliance Commercial	$1.06
Rate for Payer: Priority Health Commercial	$0.88
Rate for Payer: Priority Health PPO	$0.88

ALBUMIN QUANT

Facility

$5.53

Hospital Charge Code	3100003
Hospital Revenue Code	301
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$4.70
Rate for Payer: Cash Price	$3.59
Rate for Payer: Community Health Alliance Commercial	$4.70
Rate for Payer: Priority Health Commercial	$3.87
Rate for Payer: Priority Health PPO	$3.87

ALBUTEROL

Facility

$251.00

Hospital Charge Code	3000511
Hospital Revenue Code	301
Min. Negotiated Rate	$175.70
Max. Negotiated Rate	$213.35
Rate for Payer: Cash Price	$163.15
Rate for Payer: Community Health Alliance Commercial	$213.35
Rate for Payer: Priority Health Commercial	$175.70
Rate for Payer: Priority Health PPO	$175.70

ALCOHOL-BLOOD-SBMF

Facility

$11.54

Service Code	HCPCS 80307
Hospital Charge Code	3000495
Hospital Revenue Code	301
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$65.25
Rate for Payer: BCBS BCN 65	$65.25
Rate for Payer: Blue Care Network Medicare Advantage	$65.25
Rate for Payer: Cash Price	$7.50
Rate for Payer: Cash Price	$7.50
Rate for Payer: Community Health Alliance Commercial	$9.81
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$65.25
Rate for Payer: Meridian Health Plan Medicare	$65.25
Rate for Payer: Priority Health Commercial	$8.08
Rate for Payer: Priority Health Medicaid	$65.25
Rate for Payer: Priority Health Medicare	$65.25
Rate for Payer: Priority Health PPO	$8.08
Rate for Payer: United Health Care Medicaid	$65.25
Rate for Payer: United Health Care Medicare Advantage	$28.71

ALCOHOL DRAW (FOR POLICE)

Facility

$31.00

Service Code	HCPCS 36415
Hospital Charge Code	3003041
Hospital Revenue Code	300
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$26.35
Rate for Payer: BCBS BCN 65	$9.81
Rate for Payer: Blue Care Network Medicare Advantage	$9.81
Rate for Payer: Cash Price	$20.15
Rate for Payer: Cash Price	$20.15
Rate for Payer: Community Health Alliance Commercial	$26.35
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$9.81
Rate for Payer: Meridian Health Plan Medicare	$9.81
Rate for Payer: Priority Health Commercial	$21.70
Rate for Payer: Priority Health Medicaid	$9.81
Rate for Payer: Priority Health Medicare	$9.81
Rate for Payer: Priority Health PPO	$21.70
Rate for Payer: United Health Care Medicaid	$9.81
Rate for Payer: United Health Care Medicare Advantage	$4.32

ALCOHOL, SE.

Facility

$75.00

Service Code	HCPCS 80307
Hospital Charge Code	3004100
Hospital Revenue Code	301
Min. Negotiated Rate	$28.71
Max. Negotiated Rate	$65.25
Rate for Payer: BCBS BCN 65	$65.25
Rate for Payer: Blue Care Network Medicare Advantage	$65.25
Rate for Payer: Cash Price	$48.75
Rate for Payer: Cash Price	$48.75
Rate for Payer: Community Health Alliance Commercial	$63.75
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$65.25
Rate for Payer: Meridian Health Plan Medicare	$65.25
Rate for Payer: Priority Health Commercial	$52.50
Rate for Payer: Priority Health Medicaid	$65.25
Rate for Payer: Priority Health Medicare	$65.25
Rate for Payer: Priority Health PPO	$52.50
Rate for Payer: United Health Care Medicaid	$65.25
Rate for Payer: United Health Care Medicare Advantage	$28.71

ALCOHOL URINE

Facility

$6.00

Service Code	HCPCS 80307
Hospital Charge Code	3100822
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$65.25
Rate for Payer: BCBS BCN 65	$65.25
Rate for Payer: Blue Care Network Medicare Advantage	$65.25
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	$65.25
Rate for Payer: Meridian Health Plan Medicare	$65.25
Rate for Payer: Priority Health Commercial	$4.20
Rate for Payer: Priority Health Medicaid	$65.25
Rate for Payer: Priority Health Medicare	$65.25
Rate for Payer: Priority Health PPO	$4.20
Rate for Payer: United Health Care Medicaid	$65.25
Rate for Payer: United Health Care Medicare Advantage	$28.71

ALDOLASE

Facility

$2.00

Service Code	HCPCS 82085
Hospital Charge Code	3000420
Hospital Revenue Code	301
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$10.20
Rate for Payer: BCBS BCN 65	$10.20
Rate for Payer: Blue Care Network Medicare Advantage	$10.20
Rate for Payer: Cash Price	$1.30
Rate for Payer: Cash Price	$1.30
Rate for Payer: Community Health Alliance Commercial	$1.70
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$10.20
Rate for Payer: Meridian Health Plan Medicare	$10.20
Rate for Payer: Priority Health Commercial	$1.40
Rate for Payer: Priority Health Medicaid	$10.20
Rate for Payer: Priority Health Medicare	$10.20
Rate for Payer: Priority Health PPO	$1.40
Rate for Payer: United Health Care Medicaid	$10.20
Rate for Payer: United Health Care Medicare Advantage	$4.49

ALDOSTERONE, SERUM

Facility

$4.23

Service Code	HCPCS 82088
Hospital Charge Code	3000440
Hospital Revenue Code	301
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$42.79
Rate for Payer: BCBS BCN 65	$42.79
Rate for Payer: Blue Care Network Medicare Advantage	$42.79
Rate for Payer: Cash Price	$2.75
Rate for Payer: Cash Price	$2.75
Rate for Payer: Community Health Alliance Commercial	$3.60
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$42.79
Rate for Payer: Meridian Health Plan Medicare	$42.79
Rate for Payer: Priority Health Commercial	$2.96
Rate for Payer: Priority Health Medicaid	$42.79
Rate for Payer: Priority Health Medicare	$42.79
Rate for Payer: Priority Health PPO	$2.96
Rate for Payer: United Health Care Medicaid	$42.79
Rate for Payer: United Health Care Medicare Advantage	$18.83

ALDOSTERONE URINE 24 HR

Facility

$10.00

Service Code	HCPCS 82088
Hospital Charge Code	3007910
Hospital Revenue Code	301
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$42.79
Rate for Payer: BCBS BCN 65	$42.79
Rate for Payer: Blue Care Network Medicare Advantage	$42.79
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	$42.79
Rate for Payer: Meridian Health Plan Medicare	$42.79
Rate for Payer: Priority Health Commercial	$7.00
Rate for Payer: Priority Health Medicaid	$42.79
Rate for Payer: Priority Health Medicare	$42.79
Rate for Payer: Priority Health PPO	$7.00
Rate for Payer: United Health Care Medicaid	$42.79
Rate for Payer: United Health Care Medicare Advantage	$18.83

ALEXIS O RETRACTOR-LARGE

Facility

$150.00

Hospital Charge Code	27277533
Hospital Revenue Code	272
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

ALEXIS "O" RETRACTOR MEDIUM

Facility

$65.00

Hospital Charge Code	27278176
Hospital Revenue Code	272
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$55.25
Rate for Payer: Cash Price	$42.25
Rate for Payer: Community Health Alliance Commercial	$55.25
Rate for Payer: Priority Health Commercial	$45.50
Rate for Payer: Priority Health PPO	$45.50

ALICIAN BLUE STAIN TECH

Facility

$53.00

Service Code	HCPCS 88313
Hospital Charge Code	3100040
Hospital Revenue Code	310
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$142.73
Rate for Payer: BCBS BCN 65	$142.73
Rate for Payer: Blue Care Network Medicare Advantage	$142.73
Rate for Payer: Cash Price	$34.45
Rate for Payer: Cash Price	$34.45
Rate for Payer: Community Health Alliance Commercial	$45.05
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$142.73
Rate for Payer: Meridian Health Plan Medicare	$142.73
Rate for Payer: Priority Health Commercial	$37.10
Rate for Payer: Priority Health Medicaid	$142.73
Rate for Payer: Priority Health Medicare	$142.73
Rate for Payer: Priority Health PPO	$37.10
Rate for Payer: United Health Care Medicaid	$142.73
Rate for Payer: United Health Care Medicare Advantage	$62.80

ALI-PLAST 10 #4722

Facility

$13.00

Hospital Charge Code	27021550
Hospital Revenue Code	270
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$11.05
Rate for Payer: Cash Price	$8.45
Rate for Payer: Community Health Alliance Commercial	$11.05
Rate for Payer: Priority Health Commercial	$9.10
Rate for Payer: Priority Health PPO	$9.10

ALITRA Q

Facility

$53.00

Hospital Charge Code	27060172
Hospital Revenue Code	270
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$45.05
Rate for Payer: Cash Price	$34.45
Rate for Payer: Community Health Alliance Commercial	$45.05
Rate for Payer: Priority Health Commercial	$37.10
Rate for Payer: Priority Health PPO	$37.10

ALKALINE PHOSPHATASE

Facility

$39.00

Service Code	HCPCS 84075
Hospital Charge Code	3000480
Hospital Revenue Code	301
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$33.15
Rate for Payer: BCBS BCN 65	$5.44
Rate for Payer: Blue Care Network Medicare Advantage	$5.44
Rate for Payer: Cash Price	$25.35
Rate for Payer: Cash Price	$25.35
Rate for Payer: Community Health Alliance Commercial	$33.15
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$5.44
Rate for Payer: Meridian Health Plan Medicare	$5.44
Rate for Payer: Priority Health Commercial	$27.30
Rate for Payer: Priority Health Medicaid	$5.44
Rate for Payer: Priority Health Medicare	$5.44
Rate for Payer: Priority Health PPO	$27.30
Rate for Payer: United Health Care Medicaid	$5.44
Rate for Payer: United Health Care Medicare Advantage	$2.39

ALKALINE PHOSPHATASE

Facility

$2.50

Hospital Charge Code	3101109
Hospital Revenue Code	301
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$2.12
Rate for Payer: Cash Price	$1.63
Rate for Payer: Community Health Alliance Commercial	$2.12
Rate for Payer: Priority Health Commercial	$1.75
Rate for Payer: Priority Health PPO	$1.75

ALKALINE PHOSPHATASE, ISO

Facility

$2.50

Service Code	HCPCS 84080
Hospital Charge Code	3000500
Hospital Revenue Code	301
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$15.52
Rate for Payer: BCBS BCN 65	$15.52
Rate for Payer: Blue Care Network Medicare Advantage	$15.52
Rate for Payer: Cash Price	$1.63
Rate for Payer: Cash Price	$1.63
Rate for Payer: Community Health Alliance Commercial	$2.12
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$15.52
Rate for Payer: Meridian Health Plan Medicare	$15.52
Rate for Payer: Priority Health Commercial	$1.75
Rate for Payer: Priority Health Medicaid	$15.52
Rate for Payer: Priority Health Medicare	$15.52
Rate for Payer: Priority Health PPO	$1.75
Rate for Payer: United Health Care Medicaid	$15.52
Rate for Payer: United Health Care Medicare Advantage	$6.83

ALK REARRANGEMENT IN NSCLC

Facility

$293.00

Hospital Charge Code	3100907
Hospital Revenue Code	312
Min. Negotiated Rate	$205.10
Max. Negotiated Rate	$249.05
Rate for Payer: Cash Price	$190.45
Rate for Payer: Community Health Alliance Commercial	$249.05
Rate for Payer: Priority Health Commercial	$205.10
Rate for Payer: Priority Health PPO	$205.10

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges