Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT 1.5 12MM 03.503.412

Facility

$952.00

Hospital Revenue Code	272
Min. Negotiated Rate	$485.52
Max. Negotiated Rate	$923.44
Rate for Payer: Cash Price	$571.20
Rate for Payer: Hawaii Western Management Group Commercial	$904.40
Rate for Payer: Health Management Network Commercial	$809.20
Rate for Payer: Kaiser Permanente Commercial	$599.76
Rate for Payer: Kaiser Permanente Medicaid	$485.52
Rate for Payer: MDX Hawaii PPO	$923.44
Rate for Payer: University Health Alliance Commercial	$693.91

DRILL BIT 1.5 6MM 03.503.406

Facility

$1,390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$708.90
Max. Negotiated Rate	$1,348.30
Rate for Payer: Cash Price	$834.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,320.50
Rate for Payer: Health Management Network Commercial	$1,181.50
Rate for Payer: Kaiser Permanente Commercial	$875.70
Rate for Payer: Kaiser Permanente Medicaid	$708.90
Rate for Payer: MDX Hawaii PPO	$1,348.30
Rate for Payer: University Health Alliance Commercial	$1,013.17

DRILL BIT 1.5 6MM 03.503.406

Facility

$1,390.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,181.50
Max. Negotiated Rate	$1,348.30
Rate for Payer: Cash Price	$834.00
Rate for Payer: Health Management Network Commercial	$1,181.50
Rate for Payer: MDX Hawaii PPO	$1,348.30

DRILL BIT 1.5/70MM JC 310.14

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$295.80
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: MDX Hawaii PPO	$337.56

DRILL BIT 1.5/70MM JC 310.14

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$177.48
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Hawaii Western Management Group Commercial	$330.60
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Kaiser Permanente Commercial	$219.24
Rate for Payer: Kaiser Permanente Medicaid	$177.48
Rate for Payer: MDX Hawaii PPO	$337.56
Rate for Payer: University Health Alliance Commercial	$253.66

DRILL BIT 1.5MM, QC 86MM

Facility

$700.00

Hospital Revenue Code	272
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$679.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Hawaii Western Management Group Commercial	$665.00
Rate for Payer: Health Management Network Commercial	$595.00
Rate for Payer: Kaiser Permanente Commercial	$441.00
Rate for Payer: Kaiser Permanente Medicaid	$357.00
Rate for Payer: MDX Hawaii PPO	$679.00
Rate for Payer: University Health Alliance Commercial	$510.23

DRILL BIT 1.5MM, QC 86MM

Facility

$700.00

Hospital Revenue Code	272
Min. Negotiated Rate	$595.00
Max. Negotiated Rate	$679.00
Rate for Payer: Cash Price	$420.00
Rate for Payer: Health Management Network Commercial	$595.00
Rate for Payer: MDX Hawaii PPO	$679.00

DRILL BIT 1.5X96MM 310.16

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$295.80
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: MDX Hawaii PPO	$337.56

DRILL BIT 1.5X96MM 310.16

Facility

$348.00

Hospital Revenue Code	272
Min. Negotiated Rate	$177.48
Max. Negotiated Rate	$337.56
Rate for Payer: Cash Price	$208.80
Rate for Payer: Hawaii Western Management Group Commercial	$330.60
Rate for Payer: Health Management Network Commercial	$295.80
Rate for Payer: Kaiser Permanente Commercial	$219.24
Rate for Payer: Kaiser Permanente Medicaid	$177.48
Rate for Payer: MDX Hawaii PPO	$337.56
Rate for Payer: University Health Alliance Commercial	$253.66

DRILL BIT 1.6 705133

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 BIT 1.6 705133

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 BIT 1.7MM AR-8916-14

Facility

$495.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.75
Max. Negotiated Rate	$480.15
Rate for Payer: Cash Price	$297.00
Rate for Payer: Health Management Network Commercial	$420.75
Rate for Payer: MDX Hawaii PPO	$480.15

DRILL BIT 1.7MM AR-8916-14

Facility

$495.00

Hospital Revenue Code	272
Min. Negotiated Rate	$252.45
Max. Negotiated Rate	$480.15
Rate for Payer: Cash Price	$297.00
Rate for Payer: Hawaii Western Management Group Commercial	$470.25
Rate for Payer: Health Management Network Commercial	$420.75
Rate for Payer: Kaiser Permanente Commercial	$311.85
Rate for Payer: Kaiser Permanente Medicaid	$252.45
Rate for Payer: MDX Hawaii PPO	$480.15
Rate for Payer: University Health Alliance Commercial	$360.81

DRILL BIT 1.7NN

Facility

$890.00

Hospital Revenue Code	272
Min. Negotiated Rate	$756.50
Max. Negotiated Rate	$863.30
Rate for Payer: Cash Price	$534.00
Rate for Payer: Health Management Network Commercial	$756.50
Rate for Payer: MDX Hawaii PPO	$863.30

DRILL BIT 1.7NN

Facility

$890.00

Hospital Revenue Code	272
Min. Negotiated Rate	$453.90
Max. Negotiated Rate	$863.30
Rate for Payer: Cash Price	$534.00
Rate for Payer: Hawaii Western Management Group Commercial	$845.50
Rate for Payer: Health Management Network Commercial	$756.50
Rate for Payer: Kaiser Permanente Commercial	$560.70
Rate for Payer: Kaiser Permanente Medicaid	$453.90
Rate for Payer: MDX Hawaii PPO	$863.30
Rate for Payer: University Health Alliance Commercial	$648.72

DRILL BIT 17X280MM 03.010.029

Facility

$2,334.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,190.34
Max. Negotiated Rate	$2,263.98
Rate for Payer: Cash Price	$1,400.40
Rate for Payer: Hawaii Western Management Group Commercial	$2,217.30
Rate for Payer: Health Management Network Commercial	$1,983.90
Rate for Payer: Kaiser Permanente Commercial	$1,470.42
Rate for Payer: Kaiser Permanente Medicaid	$1,190.34
Rate for Payer: MDX Hawaii PPO	$2,263.98
Rate for Payer: University Health Alliance Commercial	$1,701.25

DRILL BIT 17X280MM 03.010.029

Facility

$2,334.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,983.90
Max. Negotiated Rate	$2,263.98
Rate for Payer: Cash Price	$1,400.40
Rate for Payer: Health Management Network Commercial	$1,983.90
Rate for Payer: MDX Hawaii PPO	$2,263.98

DRILL BIT 180X4.8MM 11001

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$241.23
Max. Negotiated Rate	$458.81
Rate for Payer: Cash Price	$283.80
Rate for Payer: Hawaii Western Management Group Commercial	$449.35
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: Kaiser Permanente Commercial	$297.99
Rate for Payer: Kaiser Permanente Medicaid	$241.23
Rate for Payer: MDX Hawaii PPO	$458.81
Rate for Payer: University Health Alliance Commercial	$344.77

DRILL BIT 180X4.8MM 11001

Facility

$473.00

Hospital Revenue Code	272
Min. Negotiated Rate	$402.05
Max. Negotiated Rate	$458.81
Rate for Payer: Cash Price	$283.80
Rate for Payer: Health Management Network Commercial	$402.05
Rate for Payer: MDX Hawaii PPO	$458.81

DRILL BIT 180X4.8MM 11001A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$290.70
Max. Negotiated Rate	$331.74
Rate for Payer: Cash Price	$205.20
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: MDX Hawaii PPO	$331.74

DRILL BIT 180X4.8MM 11001A

Facility

$342.00

Hospital Revenue Code	272
Min. Negotiated Rate	$174.42
Max. Negotiated Rate	$331.74
Rate for Payer: Cash Price	$205.20
Rate for Payer: Hawaii Western Management Group Commercial	$324.90
Rate for Payer: Health Management Network Commercial	$290.70
Rate for Payer: Kaiser Permanente Commercial	$215.46
Rate for Payer: Kaiser Permanente Medicaid	$174.42
Rate for Payer: MDX Hawaii PPO	$331.74
Rate for Payer: University Health Alliance Commercial	$249.28

DRILL BIT 1.8MM 310.510

Facility

$956.00

Hospital Revenue Code	272
Min. Negotiated Rate	$812.60
Max. Negotiated Rate	$927.32
Rate for Payer: Cash Price	$573.60
Rate for Payer: Health Management Network Commercial	$812.60
Rate for Payer: MDX Hawaii PPO	$927.32

DRILL BIT 1.8MM 310.510

Facility

$956.00

Hospital Revenue Code	272
Min. Negotiated Rate	$487.56
Max. Negotiated Rate	$927.32
Rate for Payer: Cash Price	$573.60
Rate for Payer: Hawaii Western Management Group Commercial	$908.20
Rate for Payer: Health Management Network Commercial	$812.60
Rate for Payer: Kaiser Permanente Commercial	$602.28
Rate for Payer: Kaiser Permanente Medicaid	$487.56
Rate for Payer: MDX Hawaii PPO	$927.32
Rate for Payer: University Health Alliance Commercial	$696.83

DRILL BIT 1.9MM 60-19326

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$227.46
Max. Negotiated Rate	$432.62
Rate for Payer: Cash Price	$267.60
Rate for Payer: Hawaii Western Management Group Commercial	$423.70
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: Kaiser Permanente Commercial	$280.98
Rate for Payer: Kaiser Permanente Medicaid	$227.46
Rate for Payer: MDX Hawaii PPO	$432.62
Rate for Payer: University Health Alliance Commercial	$325.09

DRILL BIT 1.9MM 60-19326

Facility

$446.00

Hospital Revenue Code	272
Min. Negotiated Rate	$379.10
Max. Negotiated Rate	$432.62
Rate for Payer: Cash Price	$267.60
Rate for Payer: Health Management Network Commercial	$379.10
Rate for Payer: MDX Hawaii PPO	$432.62

Know your out-of-pocket cost for care.

All Charges