Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

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

DRILL 4.2X300MM 1320-3042S

Facility

$944.00

Hospital Revenue Code	272
Min. Negotiated Rate	$481.44
Max. Negotiated Rate	$915.68
Rate for Payer: Cash Price	$566.40
Rate for Payer: Hawaii Western Management Group Commercial	$896.80
Rate for Payer: Health Management Network Commercial	$802.40
Rate for Payer: Kaiser Permanente Commercial	$594.72
Rate for Payer: Kaiser Permanente Medicaid	$481.44
Rate for Payer: MDX Hawaii PPO	$915.68
Rate for Payer: University Health Alliance Commercial	$688.08

DRILL 4.2X300MM 1320-3042S

Facility

$944.00

Hospital Revenue Code	272
Min. Negotiated Rate	$802.40
Max. Negotiated Rate	$915.68
Rate for Payer: Cash Price	$566.40
Rate for Payer: Health Management Network Commercial	$802.40
Rate for Payer: MDX Hawaii PPO	$915.68

DRILL 4.2X340MM 1806-4260S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$763.30
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: MDX Hawaii PPO	$871.06

DRILL 4.2X340MM 1806-4260S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$457.98
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Hawaii Western Management Group Commercial	$853.10
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Kaiser Permanente Commercial	$565.74
Rate for Payer: Kaiser Permanente Medicaid	$457.98
Rate for Payer: MDX Hawaii PPO	$871.06
Rate for Payer: University Health Alliance Commercial	$654.55

DRILL 4.5/6.5X485MM 03.010.078

Facility

$1,809.00

Hospital Revenue Code	272
Min. Negotiated Rate	$922.59
Max. Negotiated Rate	$1,754.73
Rate for Payer: Cash Price	$1,085.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,718.55
Rate for Payer: Health Management Network Commercial	$1,537.65
Rate for Payer: Kaiser Permanente Commercial	$1,139.67
Rate for Payer: Kaiser Permanente Medicaid	$922.59
Rate for Payer: MDX Hawaii PPO	$1,754.73
Rate for Payer: University Health Alliance Commercial	$1,318.58

DRILL 4.5/6.5X485MM 03.010.078

Facility

$1,809.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,537.65
Max. Negotiated Rate	$1,754.73
Rate for Payer: Cash Price	$1,085.40
Rate for Payer: Health Management Network Commercial	$1,537.65
Rate for Payer: MDX Hawaii PPO	$1,754.73

DRILL 4.6X220MM P99-110-4622

Facility

$1,037.00

Hospital Revenue Code	272
Min. Negotiated Rate	$881.45
Max. Negotiated Rate	$1,005.89
Rate for Payer: Cash Price	$622.20
Rate for Payer: Health Management Network Commercial	$881.45
Rate for Payer: MDX Hawaii PPO	$1,005.89

DRILL 4.6X220MM P99-110-4622

Facility

$1,037.00

Hospital Revenue Code	272
Min. Negotiated Rate	$528.87
Max. Negotiated Rate	$1,005.89
Rate for Payer: Cash Price	$622.20
Rate for Payer: Hawaii Western Management Group Commercial	$985.15
Rate for Payer: Health Management Network Commercial	$881.45
Rate for Payer: Kaiser Permanente Commercial	$653.31
Rate for Payer: Kaiser Permanente Medicaid	$528.87
Rate for Payer: MDX Hawaii PPO	$1,005.89
Rate for Payer: University Health Alliance Commercial	$755.87

DRILL 4.7MM CANN QR 316-0016

Facility

$1,225.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,041.25
Max. Negotiated Rate	$1,188.25
Rate for Payer: Cash Price	$735.00
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: MDX Hawaii PPO	$1,188.25

DRILL 4.7MM CANN QR 316-0016

Facility

$1,225.00

Hospital Revenue Code	272
Min. Negotiated Rate	$624.75
Max. Negotiated Rate	$1,188.25
Rate for Payer: Cash Price	$735.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,163.75
Rate for Payer: Health Management Network Commercial	$1,041.25
Rate for Payer: Kaiser Permanente Commercial	$771.75
Rate for Payer: Kaiser Permanente Medicaid	$624.75
Rate for Payer: MDX Hawaii PPO	$1,188.25
Rate for Payer: University Health Alliance Commercial	$892.90

DRILL 5.0X230 1806-5000S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$457.98
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Hawaii Western Management Group Commercial	$853.10
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Kaiser Permanente Commercial	$565.74
Rate for Payer: Kaiser Permanente Medicaid	$457.98
Rate for Payer: MDX Hawaii PPO	$871.06
Rate for Payer: University Health Alliance Commercial	$654.55

DRILL 5.0X230 1806-5000S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$763.30
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: MDX Hawaii PPO	$871.06

DRILL 6/5MM THREADED 395.923

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$761.60
Max. Negotiated Rate	$869.12
Rate for Payer: Cash Price	$537.60
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: MDX Hawaii PPO	$869.12

DRILL 6/5MM THREADED 395.923

Facility

$896.00

Hospital Revenue Code	272
Min. Negotiated Rate	$456.96
Max. Negotiated Rate	$869.12
Rate for Payer: Cash Price	$537.60
Rate for Payer: Hawaii Western Management Group Commercial	$851.20
Rate for Payer: Health Management Network Commercial	$761.60
Rate for Payer: Kaiser Permanente Commercial	$564.48
Rate for Payer: Kaiser Permanente Medicaid	$456.96
Rate for Payer: MDX Hawaii PPO	$869.12
Rate for Payer: University Health Alliance Commercial	$653.09

DRILL ACORN 7.5MM

Facility

$899.00

Hospital Revenue Code	272
Min. Negotiated Rate	$458.49
Max. Negotiated Rate	$872.03
Rate for Payer: Cash Price	$539.40
Rate for Payer: Hawaii Western Management Group Commercial	$854.05
Rate for Payer: Health Management Network Commercial	$764.15
Rate for Payer: Kaiser Permanente Commercial	$566.37
Rate for Payer: Kaiser Permanente Medicaid	$458.49
Rate for Payer: MDX Hawaii PPO	$872.03
Rate for Payer: University Health Alliance Commercial	$655.28

DRILL ACORN 7.5MM

Facility

$899.00

Hospital Revenue Code	272
Min. Negotiated Rate	$764.15
Max. Negotiated Rate	$872.03
Rate for Payer: Cash Price	$539.40
Rate for Payer: Health Management Network Commercial	$764.15
Rate for Payer: MDX Hawaii PPO	$872.03

DRILL AO 4.2X130MM 1806-4280S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$763.30
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: MDX Hawaii PPO	$871.06

DRILL AO 4.2X130MM 1806-4280S

Facility

$898.00

Hospital Revenue Code	272
Min. Negotiated Rate	$457.98
Max. Negotiated Rate	$871.06
Rate for Payer: Cash Price	$538.80
Rate for Payer: Hawaii Western Management Group Commercial	$853.10
Rate for Payer: Health Management Network Commercial	$763.30
Rate for Payer: Kaiser Permanente Commercial	$565.74
Rate for Payer: Kaiser Permanente Medicaid	$457.98
Rate for Payer: MDX Hawaii PPO	$871.06
Rate for Payer: University Health Alliance Commercial	$654.55

DRILL AO 4X180 1806-4000S

Facility

$986.00

Hospital Revenue Code	272
Min. Negotiated Rate	$838.10
Max. Negotiated Rate	$956.42
Rate for Payer: Cash Price	$591.60
Rate for Payer: Health Management Network Commercial	$838.10
Rate for Payer: MDX Hawaii PPO	$956.42

DRILL AO 4X180 1806-4000S

Facility

$986.00

Hospital Revenue Code	272
Min. Negotiated Rate	$502.86
Max. Negotiated Rate	$956.42
Rate for Payer: Cash Price	$591.60
Rate for Payer: Hawaii Western Management Group Commercial	$936.70
Rate for Payer: Health Management Network Commercial	$838.10
Rate for Payer: Kaiser Permanente Commercial	$621.18
Rate for Payer: Kaiser Permanente Medicaid	$502.86
Rate for Payer: MDX Hawaii PPO	$956.42
Rate for Payer: University Health Alliance Commercial	$718.70

DRILL #AR-1923D

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$152.49
Max. Negotiated Rate	$290.03
Rate for Payer: Cash Price	$179.40
Rate for Payer: Hawaii Western Management Group Commercial	$284.05
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: Kaiser Permanente Commercial	$188.37
Rate for Payer: Kaiser Permanente Medicaid	$152.49
Rate for Payer: MDX Hawaii PPO	$290.03
Rate for Payer: University Health Alliance Commercial	$217.94

DRILL #AR-1923D

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$254.15
Max. Negotiated Rate	$290.03
Rate for Payer: Cash Price	$179.40
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: MDX Hawaii PPO	$290.03

DRILL #AR-1923DT

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$152.49
Max. Negotiated Rate	$290.03
Rate for Payer: Cash Price	$179.40
Rate for Payer: Hawaii Western Management Group Commercial	$284.05
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: Kaiser Permanente Commercial	$188.37
Rate for Payer: Kaiser Permanente Medicaid	$152.49
Rate for Payer: MDX Hawaii PPO	$290.03
Rate for Payer: University Health Alliance Commercial	$217.94

DRILL #AR-1923DT

Facility

$299.00

Hospital Revenue Code	272
Min. Negotiated Rate	$254.15
Max. Negotiated Rate	$290.03
Rate for Payer: Cash Price	$179.40
Rate for Payer: Health Management Network Commercial	$254.15
Rate for Payer: MDX Hawaii PPO	$290.03

Know your out-of-pocket cost for care.

All Charges