Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL 2.7X40 DRLL-SSC-27040

Facility

$536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$455.60
Max. Negotiated Rate	$519.92
Rate for Payer: Cash Price	$321.60
Rate for Payer: Health Management Network Commercial	$455.60
Rate for Payer: MDX Hawaii PPO	$519.92

DRILL 2.7X40 DRLL-SSC-27040

Facility

$536.00

Hospital Revenue Code	272
Min. Negotiated Rate	$273.36
Max. Negotiated Rate	$519.92
Rate for Payer: Cash Price	$321.60
Rate for Payer: Hawaii Western Management Group Commercial	$509.20
Rate for Payer: Health Management Network Commercial	$455.60
Rate for Payer: Kaiser Permanente Commercial	$337.68
Rate for Payer: Kaiser Permanente Medicaid	$273.36
Rate for Payer: MDX Hawaii PPO	$519.92
Rate for Payer: University Health Alliance Commercial	$390.69

DRILL 2.7X70 IJS-CDC-2770

Facility

$900.00

Hospital Revenue Code	272
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$873.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Hawaii Western Management Group Commercial	$855.00
Rate for Payer: Health Management Network Commercial	$765.00
Rate for Payer: Kaiser Permanente Commercial	$567.00
Rate for Payer: Kaiser Permanente Medicaid	$459.00
Rate for Payer: MDX Hawaii PPO	$873.00
Rate for Payer: University Health Alliance Commercial	$656.01

DRILL 2.7X70 IJS-CDC-2770

Facility

$900.00

Hospital Revenue Code	272
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$873.00
Rate for Payer: Cash Price	$540.00
Rate for Payer: Health Management Network Commercial	$765.00
Rate for Payer: MDX Hawaii PPO	$873.00

DRILL 2.9MM PROX CORT 316-0317

Facility

$683.00

Hospital Revenue Code	272
Min. Negotiated Rate	$580.55
Max. Negotiated Rate	$662.51
Rate for Payer: Cash Price	$409.80
Rate for Payer: Health Management Network Commercial	$580.55
Rate for Payer: MDX Hawaii PPO	$662.51

DRILL 2.9MM PROX CORT 316-0317

Facility

$683.00

Hospital Revenue Code	272
Min. Negotiated Rate	$348.33
Max. Negotiated Rate	$662.51
Rate for Payer: Cash Price	$409.80
Rate for Payer: Hawaii Western Management Group Commercial	$648.85
Rate for Payer: Health Management Network Commercial	$580.55
Rate for Payer: Kaiser Permanente Commercial	$430.29
Rate for Payer: Kaiser Permanente Medicaid	$348.33
Rate for Payer: MDX Hawaii PPO	$662.51
Rate for Payer: University Health Alliance Commercial	$497.84

DRILL 3.0 110MM CANN SMTH

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL 3.0 110MM CANN SMTH

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.75
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$519.75
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL 3.1 703585

Facility

$860.00

Hospital Revenue Code	272
Min. Negotiated Rate	$438.60
Max. Negotiated Rate	$834.20
Rate for Payer: Cash Price	$516.00
Rate for Payer: Hawaii Western Management Group Commercial	$817.00
Rate for Payer: Health Management Network Commercial	$731.00
Rate for Payer: Kaiser Permanente Commercial	$541.80
Rate for Payer: Kaiser Permanente Medicaid	$438.60
Rate for Payer: MDX Hawaii PPO	$834.20
Rate for Payer: University Health Alliance Commercial	$626.85

DRILL 3.1 703585

Facility

$860.00

Hospital Revenue Code	272
Min. Negotiated Rate	$731.00
Max. Negotiated Rate	$834.20
Rate for Payer: Cash Price	$516.00
Rate for Payer: Health Management Network Commercial	$731.00
Rate for Payer: MDX Hawaii PPO	$834.20

DRILL 3.2 150MM DRILL-3.2/150C

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.75
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$519.75
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL 3.2 150MM DRILL-3.2/150C

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL 3.2 SHORT GRAD BRAD PT

Facility

$1,173.00

Hospital Revenue Code	272
Min. Negotiated Rate	$997.05
Max. Negotiated Rate	$1,137.81
Rate for Payer: Cash Price	$703.80
Rate for Payer: Health Management Network Commercial	$997.05
Rate for Payer: MDX Hawaii PPO	$1,137.81

DRILL 3.2 SHORT GRAD BRAD PT

Facility

$1,173.00

Hospital Revenue Code	272
Min. Negotiated Rate	$598.23
Max. Negotiated Rate	$1,137.81
Rate for Payer: Cash Price	$703.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,114.35
Rate for Payer: Health Management Network Commercial	$997.05
Rate for Payer: Kaiser Permanente Commercial	$738.99
Rate for Payer: Kaiser Permanente Medicaid	$598.23
Rate for Payer: MDX Hawaii PPO	$1,137.81
Rate for Payer: University Health Alliance Commercial	$855.00

DRILL 3.3X110MM 4806-110-33

Facility

$638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$542.30
Max. Negotiated Rate	$618.86
Rate for Payer: Cash Price	$382.80
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: MDX Hawaii PPO	$618.86

DRILL 3.3X110MM 4806-110-33

Facility

$638.00

Hospital Revenue Code	272
Min. Negotiated Rate	$325.38
Max. Negotiated Rate	$618.86
Rate for Payer: Cash Price	$382.80
Rate for Payer: Hawaii Western Management Group Commercial	$606.10
Rate for Payer: Health Management Network Commercial	$542.30
Rate for Payer: Kaiser Permanente Commercial	$401.94
Rate for Payer: Kaiser Permanente Medicaid	$325.38
Rate for Payer: MDX Hawaii PPO	$618.86
Rate for Payer: University Health Alliance Commercial	$465.04

DRILL 3.5 700353

Facility

$1,043.00

Hospital Revenue Code	272
Min. Negotiated Rate	$531.93
Max. Negotiated Rate	$1,011.71
Rate for Payer: Cash Price	$625.80
Rate for Payer: Hawaii Western Management Group Commercial	$990.85
Rate for Payer: Health Management Network Commercial	$886.55
Rate for Payer: Kaiser Permanente Commercial	$657.09
Rate for Payer: Kaiser Permanente Medicaid	$531.93
Rate for Payer: MDX Hawaii PPO	$1,011.71
Rate for Payer: University Health Alliance Commercial	$760.24

DRILL 3.5 700353

Facility

$1,043.00

Hospital Revenue Code	272
Min. Negotiated Rate	$886.55
Max. Negotiated Rate	$1,011.71
Rate for Payer: Cash Price	$625.80
Rate for Payer: Health Management Network Commercial	$886.55
Rate for Payer: MDX Hawaii PPO	$1,011.71

DRILL 3.5X130 1806-3550S

Facility

$739.00

Hospital Revenue Code	272
Min. Negotiated Rate	$376.89
Max. Negotiated Rate	$716.83
Rate for Payer: Cash Price	$443.40
Rate for Payer: Hawaii Western Management Group Commercial	$702.05
Rate for Payer: Health Management Network Commercial	$628.15
Rate for Payer: Kaiser Permanente Commercial	$465.57
Rate for Payer: Kaiser Permanente Medicaid	$376.89
Rate for Payer: MDX Hawaii PPO	$716.83
Rate for Payer: University Health Alliance Commercial	$538.66

DRILL 3.5X130 1806-3550S

Facility

$739.00

Hospital Revenue Code	272
Min. Negotiated Rate	$628.15
Max. Negotiated Rate	$716.83
Rate for Payer: Cash Price	$443.40
Rate for Payer: Health Management Network Commercial	$628.15
Rate for Payer: MDX Hawaii PPO	$716.83

DRILL 4.0 220MM DRILL-4.0/220C

Facility

$1,278.00

Hospital Revenue Code	272
Min. Negotiated Rate	$651.78
Max. Negotiated Rate	$1,239.66
Rate for Payer: Cash Price	$766.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,214.10
Rate for Payer: Health Management Network Commercial	$1,086.30
Rate for Payer: Kaiser Permanente Commercial	$805.14
Rate for Payer: Kaiser Permanente Medicaid	$651.78
Rate for Payer: MDX Hawaii PPO	$1,239.66
Rate for Payer: University Health Alliance Commercial	$931.53

DRILL 4.0 220MM DRILL-4.0/220C

Facility

$1,278.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,086.30
Max. Negotiated Rate	$1,239.66
Rate for Payer: Cash Price	$766.80
Rate for Payer: Health Management Network Commercial	$1,086.30
Rate for Payer: MDX Hawaii PPO	$1,239.66

DRILL 4.2X180MM 1806-4270S

Facility

$1,253.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,065.05
Max. Negotiated Rate	$1,215.41
Rate for Payer: Cash Price	$751.80
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: MDX Hawaii PPO	$1,215.41

DRILL 4.2X180MM 1806-4270S

Facility

$1,253.00

Hospital Revenue Code	272
Min. Negotiated Rate	$639.03
Max. Negotiated Rate	$1,215.41
Rate for Payer: Cash Price	$751.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,190.35
Rate for Payer: Health Management Network Commercial	$1,065.05
Rate for Payer: Kaiser Permanente Commercial	$789.39
Rate for Payer: Kaiser Permanente Medicaid	$639.03
Rate for Payer: MDX Hawaii PPO	$1,215.41
Rate for Payer: University Health Alliance Commercial	$913.31

DRILL 4.2X230MM 1806-4290S

Facility

$1,257.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,068.45
Max. Negotiated Rate	$1,219.29
Rate for Payer: Cash Price	$754.20
Rate for Payer: Health Management Network Commercial	$1,068.45
Rate for Payer: MDX Hawaii PPO	$1,219.29

Know your out-of-pocket cost for care.

All Charges