Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

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

DRILL BIT 3.3MM 02.00024.118

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 3.3MM 02.00024.118

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 3.3X25MM #2107-3325

Facility

$578.00

Hospital Revenue Code	272
Min. Negotiated Rate	$294.78
Max. Negotiated Rate	$560.66
Rate for Payer: Cash Price	$346.80
Rate for Payer: Hawaii Western Management Group Commercial	$549.10
Rate for Payer: Health Management Network Commercial	$491.30
Rate for Payer: Kaiser Permanente Commercial	$364.14
Rate for Payer: Kaiser Permanente Medicaid	$294.78
Rate for Payer: MDX Hawaii PPO	$560.66
Rate for Payer: University Health Alliance Commercial	$421.30

DRILL BIT 3.3X25MM #2107-3325

Facility

$578.00

Hospital Revenue Code	272
Min. Negotiated Rate	$491.30
Max. Negotiated Rate	$560.66
Rate for Payer: Cash Price	$346.80
Rate for Payer: Health Management Network Commercial	$491.30
Rate for Payer: MDX Hawaii PPO	$560.66

DRILL BIT 3.3X25MM 7005-3325S

Facility

$537.00

Hospital Revenue Code	272
Min. Negotiated Rate	$456.45
Max. Negotiated Rate	$520.89
Rate for Payer: Cash Price	$322.20
Rate for Payer: Health Management Network Commercial	$456.45
Rate for Payer: MDX Hawaii PPO	$520.89

DRILL BIT 3.3X25MM 7005-3325S

Facility

$537.00

Hospital Revenue Code	272
Min. Negotiated Rate	$273.87
Max. Negotiated Rate	$520.89
Rate for Payer: Cash Price	$322.20
Rate for Payer: Hawaii Western Management Group Commercial	$510.15
Rate for Payer: Health Management Network Commercial	$456.45
Rate for Payer: Kaiser Permanente Commercial	$338.31
Rate for Payer: Kaiser Permanente Medicaid	$273.87
Rate for Payer: MDX Hawaii PPO	$520.89
Rate for Payer: University Health Alliance Commercial	$391.42

DRILL BIT 3.5 230MM 1806-3540S

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 BIT 3.5 230MM 1806-3540S

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 BIT 3.5 AR-4160-35

Facility

$332.00

Hospital Revenue Code	272
Min. Negotiated Rate	$282.20
Max. Negotiated Rate	$322.04
Rate for Payer: Cash Price	$199.20
Rate for Payer: Health Management Network Commercial	$282.20
Rate for Payer: MDX Hawaii PPO	$322.04

DRILL BIT 3.5 AR-4160-35

Facility

$332.00

Hospital Revenue Code	272
Min. Negotiated Rate	$169.32
Max. Negotiated Rate	$322.04
Rate for Payer: Cash Price	$199.20
Rate for Payer: Hawaii Western Management Group Commercial	$315.40
Rate for Payer: Health Management Network Commercial	$282.20
Rate for Payer: Kaiser Permanente Commercial	$209.16
Rate for Payer: Kaiser Permanente Medicaid	$169.32
Rate for Payer: MDX Hawaii PPO	$322.04
Rate for Payer: University Health Alliance Commercial	$241.99

DRILL BIT 3.5MM

Facility

$1,193.00

Hospital Revenue Code	272
Min. Negotiated Rate	$608.43
Max. Negotiated Rate	$1,157.21
Rate for Payer: Cash Price	$715.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,133.35
Rate for Payer: Health Management Network Commercial	$1,014.05
Rate for Payer: Kaiser Permanente Commercial	$751.59
Rate for Payer: Kaiser Permanente Medicaid	$608.43
Rate for Payer: MDX Hawaii PPO	$1,157.21
Rate for Payer: University Health Alliance Commercial	$869.58

DRILL BIT 3.5MM

Facility

$1,193.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,014.05
Max. Negotiated Rate	$1,157.21
Rate for Payer: Cash Price	$715.80
Rate for Payer: Health Management Network Commercial	$1,014.05
Rate for Payer: MDX Hawaii PPO	$1,157.21

DRILL BIT 3.5X110MM QC 315.35

Facility

$600.00

Hospital Revenue Code	272
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$582.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Health Management Network Commercial	$510.00
Rate for Payer: MDX Hawaii PPO	$582.00

DRILL BIT 3.5X110MM QC 315.35

Facility

$600.00

Hospital Revenue Code	272
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$582.00
Rate for Payer: Cash Price	$360.00
Rate for Payer: Hawaii Western Management Group Commercial	$570.00
Rate for Payer: Health Management Network Commercial	$510.00
Rate for Payer: Kaiser Permanente Commercial	$378.00
Rate for Payer: Kaiser Permanente Medicaid	$306.00
Rate for Payer: MDX Hawaii PPO	$582.00
Rate for Payer: University Health Alliance Commercial	$437.34

DRILL BIT 3.5X6MM 210451

Facility

$431.00

Hospital Revenue Code	272
Min. Negotiated Rate	$366.35
Max. Negotiated Rate	$418.07
Rate for Payer: Cash Price	$258.60
Rate for Payer: Health Management Network Commercial	$366.35
Rate for Payer: MDX Hawaii PPO	$418.07

DRILL BIT 3.5X6MM 210451

Facility

$431.00

Hospital Revenue Code	272
Min. Negotiated Rate	$219.81
Max. Negotiated Rate	$418.07
Rate for Payer: Cash Price	$258.60
Rate for Payer: Hawaii Western Management Group Commercial	$409.45
Rate for Payer: Health Management Network Commercial	$366.35
Rate for Payer: Kaiser Permanente Commercial	$271.53
Rate for Payer: Kaiser Permanente Medicaid	$219.81
Rate for Payer: MDX Hawaii PPO	$418.07
Rate for Payer: University Health Alliance Commercial	$314.16

DRILL BIT 3.5X95MM JC 310.36

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 3.5X95MM JC 310.36

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 4.0/180MM 1-1103001

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 4.0/180MM 1-1103001

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 4.0 200MM 5085-2-040

Facility

$438.00

Hospital Revenue Code	272
Min. Negotiated Rate	$372.30
Max. Negotiated Rate	$424.86
Rate for Payer: Cash Price	$262.80
Rate for Payer: Health Management Network Commercial	$372.30
Rate for Payer: MDX Hawaii PPO	$424.86

DRILL BIT 4.0 200MM 5085-2-040

Facility

$438.00

Hospital Revenue Code	272
Min. Negotiated Rate	$223.38
Max. Negotiated Rate	$424.86
Rate for Payer: Cash Price	$262.80
Rate for Payer: Hawaii Western Management Group Commercial	$416.10
Rate for Payer: Health Management Network Commercial	$372.30
Rate for Payer: Kaiser Permanente Commercial	$275.94
Rate for Payer: Kaiser Permanente Medicaid	$223.38
Rate for Payer: MDX Hawaii PPO	$424.86
Rate for Payer: University Health Alliance Commercial	$319.26

DRILL BIT 4.0MM 2129-57-014

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 4.0MM 2129-57-014

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

Know your out-of-pocket cost for care.

All Charges