Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT 3.0MM PRECISION

Facility

$1,580.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,343.00
Max. Negotiated Rate	$1,532.60
Rate for Payer: Cash Price	$948.00
Rate for Payer: Health Management Network Commercial	$1,343.00
Rate for Payer: MDX Hawaii PPO	$1,532.60

DRILL BIT 3.0MM PRECISION

Facility

$1,580.00

Hospital Revenue Code	272
Min. Negotiated Rate	$805.80
Max. Negotiated Rate	$1,532.60
Rate for Payer: Cash Price	$948.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,501.00
Rate for Payer: Health Management Network Commercial	$1,343.00
Rate for Payer: Kaiser Permanente Commercial	$995.40
Rate for Payer: Kaiser Permanente Medicaid	$805.80
Rate for Payer: MDX Hawaii PPO	$1,532.60
Rate for Payer: University Health Alliance Commercial	$1,151.66

DRILL BIT 3.0MM QR 320-2030

Facility

$538.00

Hospital Revenue Code	272
Min. Negotiated Rate	$457.30
Max. Negotiated Rate	$521.86
Rate for Payer: Cash Price	$322.80
Rate for Payer: Health Management Network Commercial	$457.30
Rate for Payer: MDX Hawaii PPO	$521.86

DRILL BIT 3.0MM QR 320-2030

Facility

$538.00

Hospital Revenue Code	272
Min. Negotiated Rate	$274.38
Max. Negotiated Rate	$521.86
Rate for Payer: Cash Price	$322.80
Rate for Payer: Hawaii Western Management Group Commercial	$511.10
Rate for Payer: Health Management Network Commercial	$457.30
Rate for Payer: Kaiser Permanente Commercial	$338.94
Rate for Payer: Kaiser Permanente Medicaid	$274.38
Rate for Payer: MDX Hawaii PPO	$521.86
Rate for Payer: University Health Alliance Commercial	$392.15

DRILL BIT 3.1MM 5901-1126

Facility

$294.00

Hospital Revenue Code	272
Min. Negotiated Rate	$149.94
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Hawaii Western Management Group Commercial	$279.30
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: Kaiser Permanente Commercial	$185.22
Rate for Payer: Kaiser Permanente Medicaid	$149.94
Rate for Payer: MDX Hawaii PPO	$285.18
Rate for Payer: University Health Alliance Commercial	$214.30

DRILL BIT 3.1MM 5901-1126

Facility

$294.00

Hospital Revenue Code	272
Min. Negotiated Rate	$249.90
Max. Negotiated Rate	$285.18
Rate for Payer: Cash Price	$176.40
Rate for Payer: Health Management Network Commercial	$249.90
Rate for Payer: MDX Hawaii PPO	$285.18

DRILL BIT 3.2/200MM 1-1101101

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 3.2/200MM 1-1101101

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 32-467619

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 BIT 32-467619

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 BIT 3.2 CAN 01-1010-009

Facility

$1,932.00

Hospital Revenue Code	272
Min. Negotiated Rate	$985.32
Max. Negotiated Rate	$1,874.04
Rate for Payer: Cash Price	$1,159.20
Rate for Payer: Hawaii Western Management Group Commercial	$1,835.40
Rate for Payer: Health Management Network Commercial	$1,642.20
Rate for Payer: Kaiser Permanente Commercial	$1,217.16
Rate for Payer: Kaiser Permanente Medicaid	$985.32
Rate for Payer: MDX Hawaii PPO	$1,874.04
Rate for Payer: University Health Alliance Commercial	$1,408.23

DRILL BIT 3.2 CAN 01-1010-009

Facility

$1,932.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,642.20
Max. Negotiated Rate	$1,874.04
Rate for Payer: Cash Price	$1,159.20
Rate for Payer: Health Management Network Commercial	$1,642.20
Rate for Payer: MDX Hawaii PPO	$1,874.04

DRILL BIT 3.2MM 110017537

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 BIT 3.2MM 110017537

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 BIT 3.2MM 2129-57-012

Facility

$394.00

Hospital Revenue Code	272
Min. Negotiated Rate	$200.94
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$236.40
Rate for Payer: Hawaii Western Management Group Commercial	$374.30
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: Kaiser Permanente Commercial	$248.22
Rate for Payer: Kaiser Permanente Medicaid	$200.94
Rate for Payer: MDX Hawaii PPO	$382.18
Rate for Payer: University Health Alliance Commercial	$287.19

DRILL BIT 3.2MM 2129-57-012

Facility

$394.00

Hospital Revenue Code	272
Min. Negotiated Rate	$334.90
Max. Negotiated Rate	$382.18
Rate for Payer: Cash Price	$236.40
Rate for Payer: Health Management Network Commercial	$334.90
Rate for Payer: MDX Hawaii PPO	$382.18

DRILL BIT 3.2MM X 145MM

Facility

$776.00

Hospital Revenue Code	272
Min. Negotiated Rate	$659.60
Max. Negotiated Rate	$752.72
Rate for Payer: Cash Price	$465.60
Rate for Payer: Health Management Network Commercial	$659.60
Rate for Payer: MDX Hawaii PPO	$752.72

DRILL BIT 3.2MM X 145MM

Facility

$776.00

Hospital Revenue Code	272
Min. Negotiated Rate	$395.76
Max. Negotiated Rate	$752.72
Rate for Payer: Cash Price	$465.60
Rate for Payer: Hawaii Western Management Group Commercial	$737.20
Rate for Payer: Health Management Network Commercial	$659.60
Rate for Payer: Kaiser Permanente Commercial	$488.88
Rate for Payer: Kaiser Permanente Medicaid	$395.76
Rate for Payer: MDX Hawaii PPO	$752.72
Rate for Payer: University Health Alliance Commercial	$565.63

DRILL BIT 3.2MMX300MM 324.212

Facility

$841.00

Hospital Revenue Code	272
Min. Negotiated Rate	$714.85
Max. Negotiated Rate	$815.77
Rate for Payer: Cash Price	$504.60
Rate for Payer: Health Management Network Commercial	$714.85
Rate for Payer: MDX Hawaii PPO	$815.77

DRILL BIT 3.2MMX300MM 324.212

Facility

$841.00

Hospital Revenue Code	272
Min. Negotiated Rate	$428.91
Max. Negotiated Rate	$815.77
Rate for Payer: Cash Price	$504.60
Rate for Payer: Hawaii Western Management Group Commercial	$798.95
Rate for Payer: Health Management Network Commercial	$714.85
Rate for Payer: Kaiser Permanente Commercial	$529.83
Rate for Payer: Kaiser Permanente Medicaid	$428.91
Rate for Payer: MDX Hawaii PPO	$815.77
Rate for Payer: University Health Alliance Commercial	$613.00

DRILL BIT 3.2, THREE-FLUTED

Facility

$997.00

Hospital Revenue Code	272
Min. Negotiated Rate	$508.47
Max. Negotiated Rate	$967.09
Rate for Payer: Cash Price	$598.20
Rate for Payer: Hawaii Western Management Group Commercial	$947.15
Rate for Payer: Health Management Network Commercial	$847.45
Rate for Payer: Kaiser Permanente Commercial	$628.11
Rate for Payer: Kaiser Permanente Medicaid	$508.47
Rate for Payer: MDX Hawaii PPO	$967.09
Rate for Payer: University Health Alliance Commercial	$726.71

DRILL BIT 3.2, THREE-FLUTED

Facility

$997.00

Hospital Revenue Code	272
Min. Negotiated Rate	$847.45
Max. Negotiated Rate	$967.09
Rate for Payer: Cash Price	$598.20
Rate for Payer: Health Management Network Commercial	$847.45
Rate for Payer: MDX Hawaii PPO	$967.09

DRILL BIT 3.2X130MM JC 310.32

Facility

$461.00

Hospital Revenue Code	272
Min. Negotiated Rate	$391.85
Max. Negotiated Rate	$447.17
Rate for Payer: Cash Price	$276.60
Rate for Payer: Health Management Network Commercial	$391.85
Rate for Payer: MDX Hawaii PPO	$447.17

DRILL BIT 3.2X130MM JC 310.32

Facility

$461.00

Hospital Revenue Code	272
Min. Negotiated Rate	$235.11
Max. Negotiated Rate	$447.17
Rate for Payer: Cash Price	$276.60
Rate for Payer: Hawaii Western Management Group Commercial	$437.95
Rate for Payer: Health Management Network Commercial	$391.85
Rate for Payer: Kaiser Permanente Commercial	$290.43
Rate for Payer: Kaiser Permanente Medicaid	$235.11
Rate for Payer: MDX Hawaii PPO	$447.17
Rate for Payer: University Health Alliance Commercial	$336.02

DRILL BIT 3.2X315 AO 703542

Facility

$1,078.00

Hospital Revenue Code	272
Min. Negotiated Rate	$549.78
Max. Negotiated Rate	$1,045.66
Rate for Payer: Cash Price	$646.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,024.10
Rate for Payer: Health Management Network Commercial	$916.30
Rate for Payer: Kaiser Permanente Commercial	$679.14
Rate for Payer: Kaiser Permanente Medicaid	$549.78
Rate for Payer: MDX Hawaii PPO	$1,045.66
Rate for Payer: University Health Alliance Commercial	$785.75

Know your out-of-pocket cost for care.

All Charges