Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT 2.0MM FDB20

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$606.05
Max. Negotiated Rate	$691.61
Rate for Payer: Cash Price	$427.80
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: MDX Hawaii PPO	$691.61

DRILL BIT 2.0X150MM QC 310.221

Facility

$1,509.00

Hospital Revenue Code	272
Min. Negotiated Rate	$769.59
Max. Negotiated Rate	$1,463.73
Rate for Payer: Cash Price	$905.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,433.55
Rate for Payer: Health Management Network Commercial	$1,282.65
Rate for Payer: Kaiser Permanente Commercial	$950.67
Rate for Payer: Kaiser Permanente Medicaid	$769.59
Rate for Payer: MDX Hawaii PPO	$1,463.73
Rate for Payer: University Health Alliance Commercial	$1,099.91

DRILL BIT 2.0X150MM QC 310.221

Facility

$1,509.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,282.65
Max. Negotiated Rate	$1,463.73
Rate for Payer: Cash Price	$905.40
Rate for Payer: Health Management Network Commercial	$1,282.65
Rate for Payer: MDX Hawaii PPO	$1,463.73

DRILL BIT 2.2MM NS 231200200

Facility

$439.00

Hospital Revenue Code	272
Min. Negotiated Rate	$373.15
Max. Negotiated Rate	$425.83
Rate for Payer: Cash Price	$263.40
Rate for Payer: Health Management Network Commercial	$373.15
Rate for Payer: MDX Hawaii PPO	$425.83

DRILL BIT 2.2MM NS 231200200

Facility

$439.00

Hospital Revenue Code	272
Min. Negotiated Rate	$223.89
Max. Negotiated Rate	$425.83
Rate for Payer: Cash Price	$263.40
Rate for Payer: Hawaii Western Management Group Commercial	$417.05
Rate for Payer: Health Management Network Commercial	$373.15
Rate for Payer: Kaiser Permanente Commercial	$276.57
Rate for Payer: Kaiser Permanente Medicaid	$223.89
Rate for Payer: MDX Hawaii PPO	$425.83
Rate for Payer: University Health Alliance Commercial	$319.99

DRILL BIT 240X4.8MM 11002A

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 240X4.8MM 11002A

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 240X4.8MM 1-1100201

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$447.95
Max. Negotiated Rate	$511.19
Rate for Payer: Cash Price	$316.20
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: MDX Hawaii PPO	$511.19

DRILL BIT 240X4.8MM 1-1100201

Facility

$527.00

Hospital Revenue Code	272
Min. Negotiated Rate	$268.77
Max. Negotiated Rate	$511.19
Rate for Payer: Cash Price	$316.20
Rate for Payer: Hawaii Western Management Group Commercial	$500.65
Rate for Payer: Health Management Network Commercial	$447.95
Rate for Payer: Kaiser Permanente Commercial	$332.01
Rate for Payer: Kaiser Permanente Medicaid	$268.77
Rate for Payer: MDX Hawaii PPO	$511.19
Rate for Payer: University Health Alliance Commercial	$384.13

DRILL BIT 2.5 03.133.103

Facility

$756.00

Hospital Revenue Code	272
Min. Negotiated Rate	$385.56
Max. Negotiated Rate	$733.32
Rate for Payer: Cash Price	$453.60
Rate for Payer: Hawaii Western Management Group Commercial	$718.20
Rate for Payer: Health Management Network Commercial	$642.60
Rate for Payer: Kaiser Permanente Commercial	$476.28
Rate for Payer: Kaiser Permanente Medicaid	$385.56
Rate for Payer: MDX Hawaii PPO	$733.32
Rate for Payer: University Health Alliance Commercial	$551.05

DRILL BIT 2.5 03.133.103

Facility

$756.00

Hospital Revenue Code	272
Min. Negotiated Rate	$642.60
Max. Negotiated Rate	$733.32
Rate for Payer: Cash Price	$453.60
Rate for Payer: Health Management Network Commercial	$642.60
Rate for Payer: MDX Hawaii PPO	$733.32

DRILL BIT 2.5/95MM JC 310.24

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 2.5/95MM JC 310.24

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 2.5 CALI AR-8943-42

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$182.07
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$214.20
Rate for Payer: Hawaii Western Management Group Commercial	$339.15
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: Kaiser Permanente Commercial	$224.91
Rate for Payer: Kaiser Permanente Medicaid	$182.07
Rate for Payer: MDX Hawaii PPO	$346.29
Rate for Payer: University Health Alliance Commercial	$260.22

DRILL BIT 2.5 CALI AR-8943-42

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$303.45
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$214.20
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: MDX Hawaii PPO	$346.29

DRILL BIT 2.5MM 829029070

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$606.05
Max. Negotiated Rate	$691.61
Rate for Payer: Cash Price	$427.80
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: MDX Hawaii PPO	$691.61

DRILL BIT 2.5MM 829029070

Facility

$713.00

Hospital Revenue Code	272
Min. Negotiated Rate	$363.63
Max. Negotiated Rate	$691.61
Rate for Payer: Cash Price	$427.80
Rate for Payer: Hawaii Western Management Group Commercial	$677.35
Rate for Payer: Health Management Network Commercial	$606.05
Rate for Payer: Kaiser Permanente Commercial	$449.19
Rate for Payer: Kaiser Permanente Medicaid	$363.63
Rate for Payer: MDX Hawaii PPO	$691.61
Rate for Payer: University Health Alliance Commercial	$519.71

DRILL BIT 2.5MM AR-8943-30

Facility

$340.00

Hospital Revenue Code	272
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$329.80
Rate for Payer: Cash Price	$204.00
Rate for Payer: Hawaii Western Management Group Commercial	$323.00
Rate for Payer: Health Management Network Commercial	$289.00
Rate for Payer: Kaiser Permanente Commercial	$214.20
Rate for Payer: Kaiser Permanente Medicaid	$173.40
Rate for Payer: MDX Hawaii PPO	$329.80
Rate for Payer: University Health Alliance Commercial	$247.83

DRILL BIT 2.5MM AR-8943-30

Facility

$340.00

Hospital Revenue Code	272
Min. Negotiated Rate	$289.00
Max. Negotiated Rate	$329.80
Rate for Payer: Cash Price	$204.00
Rate for Payer: Health Management Network Commercial	$289.00
Rate for Payer: MDX Hawaii PPO	$329.80

DRILL BIT 2.5MM CAL AR-8943-13

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$303.45
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$214.20
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: MDX Hawaii PPO	$346.29

DRILL BIT 2.5MM CAL AR-8943-13

Facility

$357.00

Hospital Revenue Code	272
Min. Negotiated Rate	$182.07
Max. Negotiated Rate	$346.29
Rate for Payer: Cash Price	$214.20
Rate for Payer: Hawaii Western Management Group Commercial	$339.15
Rate for Payer: Health Management Network Commercial	$303.45
Rate for Payer: Kaiser Permanente Commercial	$224.91
Rate for Payer: Kaiser Permanente Medicaid	$182.07
Rate for Payer: MDX Hawaii PPO	$346.29
Rate for Payer: University Health Alliance Commercial	$260.22

DRILL BIT 2.5MM DB25

Facility

$675.00

Hospital Revenue Code	272
Min. Negotiated Rate	$344.25
Max. Negotiated Rate	$654.75
Rate for Payer: Cash Price	$405.00
Rate for Payer: Hawaii Western Management Group Commercial	$641.25
Rate for Payer: Health Management Network Commercial	$573.75
Rate for Payer: Kaiser Permanente Commercial	$425.25
Rate for Payer: Kaiser Permanente Medicaid	$344.25
Rate for Payer: MDX Hawaii PPO	$654.75
Rate for Payer: University Health Alliance Commercial	$492.01

DRILL BIT 2.5MM DB25

Facility

$675.00

Hospital Revenue Code	272
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$654.75
Rate for Payer: Cash Price	$405.00
Rate for Payer: Health Management Network Commercial	$573.75
Rate for Payer: MDX Hawaii PPO	$654.75

DRILL BIT 2.5MMX135MM 542020

Facility

$1,099.00

Hospital Revenue Code	272
Min. Negotiated Rate	$934.15
Max. Negotiated Rate	$1,066.03
Rate for Payer: Cash Price	$659.40
Rate for Payer: Health Management Network Commercial	$934.15
Rate for Payer: MDX Hawaii PPO	$1,066.03

DRILL BIT 2.5MMX135MM 542020

Facility

$1,099.00

Hospital Revenue Code	272
Min. Negotiated Rate	$560.49
Max. Negotiated Rate	$1,066.03
Rate for Payer: Cash Price	$659.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,044.05
Rate for Payer: Health Management Network Commercial	$934.15
Rate for Payer: Kaiser Permanente Commercial	$692.37
Rate for Payer: Kaiser Permanente Medicaid	$560.49
Rate for Payer: MDX Hawaii PPO	$1,066.03
Rate for Payer: University Health Alliance Commercial	$801.06

Know your out-of-pocket cost for care.

All Charges