Sturgis Hospital Inc.

All Charges

Charge

Type

Setting

Price

HBVS-2

Facility

$3.60

Hospital Charge Code	3102490
Hospital Revenue Code	300
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$3.06
Rate for Payer: Cash Price	$2.34
Rate for Payer: Community Health Alliance Commercial	$3.06
Rate for Payer: Priority Health Commercial	$2.52
Rate for Payer: Priority Health PPO	$2.52

HBVS-3

Facility

$3.61

Hospital Charge Code	3102491
Hospital Revenue Code	300
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$3.07
Rate for Payer: Cash Price	$2.35
Rate for Payer: Community Health Alliance Commercial	$3.07
Rate for Payer: Priority Health Commercial	$2.53
Rate for Payer: Priority Health PPO	$2.53

HCAB-1

Facility

$13.83

Hospital Charge Code	3009414
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$11.76
Rate for Payer: Cash Price	$8.99
Rate for Payer: Community Health Alliance Commercial	$11.76
Rate for Payer: Priority Health Commercial	$9.68
Rate for Payer: Priority Health PPO	$9.68

HCAB-2

Facility

$13.83

Hospital Charge Code	3009415
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$11.76
Rate for Payer: Cash Price	$8.99
Rate for Payer: Community Health Alliance Commercial	$11.76
Rate for Payer: Priority Health Commercial	$9.68
Rate for Payer: Priority Health PPO	$9.68

HCAB-3

Facility

$13.84

Hospital Charge Code	3009417
Hospital Revenue Code	300
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$11.76
Rate for Payer: Cash Price	$9.00
Rate for Payer: Community Health Alliance Commercial	$11.76
Rate for Payer: Priority Health Commercial	$9.69
Rate for Payer: Priority Health PPO	$9.69

HCP-1

Facility

$9.00

Hospital Charge Code	3102612
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

HCP-2

Facility

$9.00

Hospital Charge Code	3102613
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

HCP-3

Facility

$9.00

Hospital Charge Code	3102614
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

HCP-4

Facility

$9.00

Hospital Charge Code	3102615
Hospital Revenue Code	300
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$7.65
Rate for Payer: Cash Price	$5.85
Rate for Payer: Community Health Alliance Commercial	$7.65
Rate for Payer: Priority Health Commercial	$6.30
Rate for Payer: Priority Health PPO	$6.30

HCV QUANT RFX GENO

Facility

$55.00

Hospital Charge Code	31027714
Hospital Revenue Code	300
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$46.75
Rate for Payer: Cash Price	$35.75
Rate for Payer: Community Health Alliance Commercial	$46.75
Rate for Payer: Priority Health Commercial	$38.50
Rate for Payer: Priority Health PPO	$38.50

HCVSIA

Facility

$155.00

Service Code	HCPCS 86804
Hospital Charge Code	3005010
Hospital Revenue Code	302
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$131.75
Rate for Payer: BCBS BCN 65	$16.26
Rate for Payer: Blue Care Network Medicare Advantage	$16.26
Rate for Payer: Cash Price	$100.75
Rate for Payer: Cash Price	$100.75
Rate for Payer: Community Health Alliance Commercial	$131.75
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$16.26
Rate for Payer: Meridian Health Plan Medicare	$16.26
Rate for Payer: Priority Health Commercial	$108.50
Rate for Payer: Priority Health Medicaid	$16.26
Rate for Payer: Priority Health Medicare	$16.26
Rate for Payer: Priority Health PPO	$108.50
Rate for Payer: United Health Care Medicaid	$16.26
Rate for Payer: United Health Care Medicare Advantage	$7.16

HDL DIRECT MEASUREMENT

Facility

$38.00

Service Code	HCPCS 83718
Hospital Charge Code	3005060
Hospital Revenue Code	301
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$32.30
Rate for Payer: BCBS BCN 65	$8.60
Rate for Payer: Blue Care Network Medicare Advantage	$8.60
Rate for Payer: Cash Price	$24.70
Rate for Payer: Cash Price	$24.70
Rate for Payer: Community Health Alliance Commercial	$32.30
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$8.60
Rate for Payer: Meridian Health Plan Medicare	$8.60
Rate for Payer: Priority Health Commercial	$26.60
Rate for Payer: Priority Health Medicaid	$8.60
Rate for Payer: Priority Health Medicare	$8.60
Rate for Payer: Priority Health PPO	$26.60
Rate for Payer: United Health Care Medicaid	$8.60
Rate for Payer: United Health Care Medicare Advantage	$3.78

HDN ABSCREEN-SBMF

Facility

$7.40

Hospital Charge Code	3102713
Hospital Revenue Code	300
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$6.29
Rate for Payer: Cash Price	$4.81
Rate for Payer: Community Health Alliance Commercial	$6.29
Rate for Payer: Priority Health Commercial	$5.18
Rate for Payer: Priority Health PPO	$5.18

HDN AB TITER 2ND AB

Facility

$18.50

Hospital Charge Code	3101307
Hospital Revenue Code	300
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$15.72
Rate for Payer: Cash Price	$12.03
Rate for Payer: Community Health Alliance Commercial	$15.72
Rate for Payer: Priority Health Commercial	$12.95
Rate for Payer: Priority Health PPO	$12.95

HDN AB TITER-SBMF

Facility

$18.50

Hospital Charge Code	3102723
Hospital Revenue Code	300
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$15.72
Rate for Payer: Cash Price	$12.03
Rate for Payer: Community Health Alliance Commercial	$15.72
Rate for Payer: Priority Health Commercial	$12.95
Rate for Payer: Priority Health PPO	$12.95

HDV-LC

Facility

$22.00

Hospital Charge Code	31027434
Hospital Revenue Code	300
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$18.70
Rate for Payer: Cash Price	$14.30
Rate for Payer: Community Health Alliance Commercial	$18.70
Rate for Payer: Priority Health Commercial	$15.40
Rate for Payer: Priority Health PPO	$15.40

HEAD HALTER FOR CERV TRACTION

Facility

$105.00

Hospital Charge Code	27012500
Hospital Revenue Code	270
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$89.25
Rate for Payer: Cash Price	$68.25
Rate for Payer: Community Health Alliance Commercial	$89.25
Rate for Payer: Priority Health Commercial	$73.50
Rate for Payer: Priority Health PPO	$73.50

HEAVY METAL QUAN MOLYBDENUM

Facility

$80.00

Hospital Charge Code	3100171
Hospital Revenue Code	301
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

HEAVY METAL URINE 24/R

Facility

$10.00

Hospital Charge Code	3005011
Hospital Revenue Code	301
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$8.50
Rate for Payer: Cash Price	$6.50
Rate for Payer: Community Health Alliance Commercial	$8.50
Rate for Payer: Priority Health Commercial	$7.00
Rate for Payer: Priority Health PPO	$7.00

HEEL PROTECTOR, "SURE STAY"

Facility

$42.00

Hospital Charge Code	27063573
Hospital Revenue Code	270
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$35.70
Rate for Payer: Cash Price	$27.30
Rate for Payer: Community Health Alliance Commercial	$35.70
Rate for Payer: Priority Health Commercial	$29.40
Rate for Payer: Priority Health PPO	$29.40

HELICOBACTER PYLORI ANTIBODY

Facility

$87.00

Service Code	HCPCS 86677
Hospital Charge Code	3000521
Hospital Revenue Code	302
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$73.95
Rate for Payer: BCBS BCN 65	$17.69
Rate for Payer: Blue Care Network Medicare Advantage	$17.69
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	$17.69
Rate for Payer: Meridian Health Plan Medicare	$17.69
Rate for Payer: Priority Health Commercial	$60.90
Rate for Payer: Priority Health Medicaid	$17.69
Rate for Payer: Priority Health Medicare	$17.69
Rate for Payer: Priority Health PPO	$60.90
Rate for Payer: United Health Care Medicaid	$17.69
Rate for Payer: United Health Care Medicare Advantage	$7.78

HELICOBACTER PYLORI IGA

Facility

$5.77

Hospital Charge Code	3100795
Hospital Revenue Code	300
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.90
Rate for Payer: Cash Price	$3.75
Rate for Payer: Community Health Alliance Commercial	$4.90
Rate for Payer: Priority Health Commercial	$4.04
Rate for Payer: Priority Health PPO	$4.04

HELICOBACTER PYLORI IGG

Facility

$5.77

Hospital Charge Code	3100796
Hospital Revenue Code	300
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.90
Rate for Payer: Cash Price	$3.75
Rate for Payer: Community Health Alliance Commercial	$4.90
Rate for Payer: Priority Health Commercial	$4.04
Rate for Payer: Priority Health PPO	$4.04

HELICOBACTER PYLORI IGM

Facility

$5.77

Hospital Charge Code	3100797
Hospital Revenue Code	300
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.90
Rate for Payer: Cash Price	$3.75
Rate for Payer: Community Health Alliance Commercial	$4.90
Rate for Payer: Priority Health Commercial	$4.04
Rate for Payer: Priority Health PPO	$4.04

HELICOBACTER PYLORI TITER

Facility

$154.00

Service Code	HCPCS 86677
Hospital Charge Code	3000522
Hospital Revenue Code	302
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$130.90
Rate for Payer: BCBS BCN 65	$17.69
Rate for Payer: Blue Care Network Medicare Advantage	$17.69
Rate for Payer: Cash Price	$100.10
Rate for Payer: Cash Price	$100.10
Rate for Payer: Community Health Alliance Commercial	$130.90
Rate for Payer: Meridian Health Plan Medicaid/Meridian MI Child	$17.69
Rate for Payer: Meridian Health Plan Medicare	$17.69
Rate for Payer: Priority Health Commercial	$107.80
Rate for Payer: Priority Health Medicaid	$17.69
Rate for Payer: Priority Health Medicare	$17.69
Rate for Payer: Priority Health PPO	$107.80
Rate for Payer: United Health Care Medicaid	$17.69
Rate for Payer: United Health Care Medicare Advantage	$7.78

Sturgis Hospital Inc.

Know your out-of-pocket cost for care.

All Charges