Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT 4.2MM X 145MM

Facility

$938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$797.30
Max. Negotiated Rate	$909.86
Rate for Payer: Cash Price	$562.80
Rate for Payer: Health Management Network Commercial	$797.30
Rate for Payer: MDX Hawaii PPO	$909.86

DRILL BIT 4.2MM X 145MM

Facility

$938.00

Hospital Revenue Code	272
Min. Negotiated Rate	$478.38
Max. Negotiated Rate	$909.86
Rate for Payer: Cash Price	$562.80
Rate for Payer: Hawaii Western Management Group Commercial	$891.10
Rate for Payer: Health Management Network Commercial	$797.30
Rate for Payer: Kaiser Permanente Commercial	$590.94
Rate for Payer: Kaiser Permanente Medicaid	$478.38
Rate for Payer: MDX Hawaii PPO	$909.86
Rate for Payer: University Health Alliance Commercial	$683.71

DRILL BIT 4.2X145MM 03.010.101

Facility

$993.00

Hospital Revenue Code	272
Min. Negotiated Rate	$506.43
Max. Negotiated Rate	$963.21
Rate for Payer: Cash Price	$595.80
Rate for Payer: Hawaii Western Management Group Commercial	$943.35
Rate for Payer: Health Management Network Commercial	$844.05
Rate for Payer: Kaiser Permanente Commercial	$625.59
Rate for Payer: Kaiser Permanente Medicaid	$506.43
Rate for Payer: MDX Hawaii PPO	$963.21
Rate for Payer: University Health Alliance Commercial	$723.80

DRILL BIT 4.2X145MM 03.010.101

Facility

$993.00

Hospital Revenue Code	272
Min. Negotiated Rate	$844.05
Max. Negotiated Rate	$963.21
Rate for Payer: Cash Price	$595.80
Rate for Payer: Health Management Network Commercial	$844.05
Rate for Payer: MDX Hawaii PPO	$963.21

DRILL BIT 4.2X145MM 03.010.104

Facility

$880.00

Hospital Revenue Code	272
Min. Negotiated Rate	$748.00
Max. Negotiated Rate	$853.60
Rate for Payer: Cash Price	$528.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: MDX Hawaii PPO	$853.60

DRILL BIT 4.2X145MM 03.010.104

Facility

$880.00

Hospital Revenue Code	272
Min. Negotiated Rate	$448.80
Max. Negotiated Rate	$853.60
Rate for Payer: Cash Price	$528.00
Rate for Payer: Hawaii Western Management Group Commercial	$836.00
Rate for Payer: Health Management Network Commercial	$748.00
Rate for Payer: Kaiser Permanente Commercial	$554.40
Rate for Payer: Kaiser Permanente Medicaid	$448.80
Rate for Payer: MDX Hawaii PPO	$853.60
Rate for Payer: University Health Alliance Commercial	$641.43

DRILL BIT 4.2X330MM 03.010.061

Facility

$1,148.00

Hospital Revenue Code	272
Min. Negotiated Rate	$585.48
Max. Negotiated Rate	$1,113.56
Rate for Payer: Cash Price	$688.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,090.60
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: Kaiser Permanente Commercial	$723.24
Rate for Payer: Kaiser Permanente Medicaid	$585.48
Rate for Payer: MDX Hawaii PPO	$1,113.56
Rate for Payer: University Health Alliance Commercial	$836.78

DRILL BIT 4.2X330MM 03.010.061

Facility

$1,148.00

Hospital Revenue Code	272
Min. Negotiated Rate	$975.80
Max. Negotiated Rate	$1,113.56
Rate for Payer: Cash Price	$688.80
Rate for Payer: Health Management Network Commercial	$975.80
Rate for Payer: MDX Hawaii PPO	$1,113.56

DRILL BIT 4.3MM 02.00024.002

Facility

$980.00

Hospital Revenue Code	272
Min. Negotiated Rate	$499.80
Max. Negotiated Rate	$950.60
Rate for Payer: Cash Price	$588.00
Rate for Payer: Hawaii Western Management Group Commercial	$931.00
Rate for Payer: Health Management Network Commercial	$833.00
Rate for Payer: Kaiser Permanente Commercial	$617.40
Rate for Payer: Kaiser Permanente Medicaid	$499.80
Rate for Payer: MDX Hawaii PPO	$950.60
Rate for Payer: University Health Alliance Commercial	$714.32

DRILL BIT 4.3MM 02.00024.002

Facility

$980.00

Hospital Revenue Code	272
Min. Negotiated Rate	$833.00
Max. Negotiated Rate	$950.60
Rate for Payer: Cash Price	$588.00
Rate for Payer: Health Management Network Commercial	$833.00
Rate for Payer: MDX Hawaii PPO	$950.60

DRILL BIT 4.3MM 02.00024.346

Facility

$840.00

Hospital Revenue Code	272
Min. Negotiated Rate	$714.00
Max. Negotiated Rate	$814.80
Rate for Payer: Cash Price	$504.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: MDX Hawaii PPO	$814.80

DRILL BIT 4.3MM 02.00024.346

Facility

$840.00

Hospital Revenue Code	272
Min. Negotiated Rate	$428.40
Max. Negotiated Rate	$814.80
Rate for Payer: Cash Price	$504.00
Rate for Payer: Hawaii Western Management Group Commercial	$798.00
Rate for Payer: Health Management Network Commercial	$714.00
Rate for Payer: Kaiser Permanente Commercial	$529.20
Rate for Payer: Kaiser Permanente Medicaid	$428.40
Rate for Payer: MDX Hawaii PPO	$814.80
Rate for Payer: University Health Alliance Commercial	$612.28

DRILL BIT 4.3MMX300MM 324.213

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 4.3MMX300MM 324.213

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 4.3X196 705078

Facility

$1,013.00

Hospital Revenue Code	272
Min. Negotiated Rate	$861.05
Max. Negotiated Rate	$982.61
Rate for Payer: Cash Price	$607.80
Rate for Payer: Health Management Network Commercial	$861.05
Rate for Payer: MDX Hawaii PPO	$982.61

DRILL BIT 4.3X196 705078

Facility

$1,013.00

Hospital Revenue Code	272
Min. Negotiated Rate	$516.63
Max. Negotiated Rate	$982.61
Rate for Payer: Cash Price	$607.80
Rate for Payer: Hawaii Western Management Group Commercial	$962.35
Rate for Payer: Health Management Network Commercial	$861.05
Rate for Payer: Kaiser Permanente Commercial	$638.19
Rate for Payer: Kaiser Permanente Medicaid	$516.63
Rate for Payer: MDX Hawaii PPO	$982.61
Rate for Payer: University Health Alliance Commercial	$738.38

DRILL BIT 4.3X216 SHRT 705043

Facility

$1,024.00

Hospital Revenue Code	272
Min. Negotiated Rate	$522.24
Max. Negotiated Rate	$993.28
Rate for Payer: Cash Price	$614.40
Rate for Payer: Hawaii Western Management Group Commercial	$972.80
Rate for Payer: Health Management Network Commercial	$870.40
Rate for Payer: Kaiser Permanente Commercial	$645.12
Rate for Payer: Kaiser Permanente Medicaid	$522.24
Rate for Payer: MDX Hawaii PPO	$993.28
Rate for Payer: University Health Alliance Commercial	$746.39

DRILL BIT 4.3X216 SHRT 705043

Facility

$1,024.00

Hospital Revenue Code	272
Min. Negotiated Rate	$870.40
Max. Negotiated Rate	$993.28
Rate for Payer: Cash Price	$614.40
Rate for Payer: Health Management Network Commercial	$870.40
Rate for Payer: MDX Hawaii PPO	$993.28

DRILL BIT 4.3X300 02.00024.003

Facility

$1,015.00

Hospital Revenue Code	272
Min. Negotiated Rate	$517.65
Max. Negotiated Rate	$984.55
Rate for Payer: Cash Price	$609.00
Rate for Payer: Hawaii Western Management Group Commercial	$964.25
Rate for Payer: Health Management Network Commercial	$862.75
Rate for Payer: Kaiser Permanente Commercial	$639.45
Rate for Payer: Kaiser Permanente Medicaid	$517.65
Rate for Payer: MDX Hawaii PPO	$984.55
Rate for Payer: University Health Alliance Commercial	$739.83

DRILL BIT 4.3X300 02.00024.003

Facility

$1,015.00

Hospital Revenue Code	272
Min. Negotiated Rate	$862.75
Max. Negotiated Rate	$984.55
Rate for Payer: Cash Price	$609.00
Rate for Payer: Health Management Network Commercial	$862.75
Rate for Payer: MDX Hawaii PPO	$984.55

DRILL BIT 4.3X315 AO 703541

Facility

$888.00

Hospital Revenue Code	272
Min. Negotiated Rate	$754.80
Max. Negotiated Rate	$861.36
Rate for Payer: Cash Price	$532.80
Rate for Payer: Health Management Network Commercial	$754.80
Rate for Payer: MDX Hawaii PPO	$861.36

DRILL BIT 4.3X315 AO 703541

Facility

$888.00

Hospital Revenue Code	272
Min. Negotiated Rate	$452.88
Max. Negotiated Rate	$861.36
Rate for Payer: Cash Price	$532.80
Rate for Payer: Hawaii Western Management Group Commercial	$843.60
Rate for Payer: Health Management Network Commercial	$754.80
Rate for Payer: Kaiser Permanente Commercial	$559.44
Rate for Payer: Kaiser Permanente Medicaid	$452.88
Rate for Payer: MDX Hawaii PPO	$861.36
Rate for Payer: University Health Alliance Commercial	$647.26

DRILL BIT 4.5MM 180MM 700354

Facility

$824.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.24
Max. Negotiated Rate	$799.28
Rate for Payer: Cash Price	$494.40
Rate for Payer: Hawaii Western Management Group Commercial	$782.80
Rate for Payer: Health Management Network Commercial	$700.40
Rate for Payer: Kaiser Permanente Commercial	$519.12
Rate for Payer: Kaiser Permanente Medicaid	$420.24
Rate for Payer: MDX Hawaii PPO	$799.28
Rate for Payer: University Health Alliance Commercial	$600.61

DRILL BIT 4.5MM 180MM 700354

Facility

$824.00

Hospital Revenue Code	272
Min. Negotiated Rate	$700.40
Max. Negotiated Rate	$799.28
Rate for Payer: Cash Price	$494.40
Rate for Payer: Health Management Network Commercial	$700.40
Rate for Payer: MDX Hawaii PPO	$799.28

DRILL BIT 4.5x10MM #2318-45-06

Facility

$213.00

Hospital Revenue Code	272
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$206.61
Rate for Payer: Cash Price	$127.80
Rate for Payer: Health Management Network Commercial	$181.05
Rate for Payer: MDX Hawaii PPO	$206.61

Know your out-of-pocket cost for care.

All Charges