Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT CAN 4.8/280MM 11.012

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$530.40
Max. Negotiated Rate	$605.28
Rate for Payer: Cash Price	$374.40
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: MDX Hawaii PPO	$605.28

DRILL BIT CAN 4.8/280MM 11012A

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 CAN 4.8/280MM 11012A

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 CANN 14MM 03.033.004

Facility

$2,081.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,061.31
Max. Negotiated Rate	$2,018.57
Rate for Payer: Cash Price	$1,248.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,976.95
Rate for Payer: Health Management Network Commercial	$1,768.85
Rate for Payer: Kaiser Permanente Commercial	$1,311.03
Rate for Payer: Kaiser Permanente Medicaid	$1,061.31
Rate for Payer: MDX Hawaii PPO	$2,018.57
Rate for Payer: University Health Alliance Commercial	$1,516.84

DRILL BIT CANN 14MM 03.033.004

Facility

$2,081.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,768.85
Max. Negotiated Rate	$2,018.57
Rate for Payer: Cash Price	$1,248.60
Rate for Payer: Health Management Network Commercial	$1,768.85
Rate for Payer: MDX Hawaii PPO	$2,018.57

DRILL BIT CANN 14MM 03.033.005

Facility

$1,920.00

Hospital Revenue Code	272
Min. Negotiated Rate	$979.20
Max. Negotiated Rate	$1,862.40
Rate for Payer: Cash Price	$1,152.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,824.00
Rate for Payer: Health Management Network Commercial	$1,632.00
Rate for Payer: Kaiser Permanente Commercial	$1,209.60
Rate for Payer: Kaiser Permanente Medicaid	$979.20
Rate for Payer: MDX Hawaii PPO	$1,862.40
Rate for Payer: University Health Alliance Commercial	$1,399.49

DRILL BIT CANN 14MM 03.033.005

Facility

$1,920.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,632.00
Max. Negotiated Rate	$1,862.40
Rate for Payer: Cash Price	$1,152.00
Rate for Payer: Health Management Network Commercial	$1,632.00
Rate for Payer: MDX Hawaii PPO	$1,862.40

DRILL BIT CANN 2.7MM 320-2627

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$449.82
Max. Negotiated Rate	$855.54
Rate for Payer: Cash Price	$529.20
Rate for Payer: Hawaii Western Management Group Commercial	$837.90
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: Kaiser Permanente Commercial	$555.66
Rate for Payer: Kaiser Permanente Medicaid	$449.82
Rate for Payer: MDX Hawaii PPO	$855.54
Rate for Payer: University Health Alliance Commercial	$642.89

DRILL BIT CANN 2.7MM 320-2627

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$749.70
Max. Negotiated Rate	$855.54
Rate for Payer: Cash Price	$529.20
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: MDX Hawaii PPO	$855.54

DRILL BIT CANN 3.2/200MM 11011

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$530.40
Max. Negotiated Rate	$605.28
Rate for Payer: Cash Price	$374.40
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: MDX Hawaii PPO	$605.28

DRILL BIT CANN 3.2/200MM 11011

Facility

$624.00

Hospital Revenue Code	272
Min. Negotiated Rate	$318.24
Max. Negotiated Rate	$605.28
Rate for Payer: Cash Price	$374.40
Rate for Payer: Hawaii Western Management Group Commercial	$592.80
Rate for Payer: Health Management Network Commercial	$530.40
Rate for Payer: Kaiser Permanente Commercial	$393.12
Rate for Payer: Kaiser Permanente Medicaid	$318.24
Rate for Payer: MDX Hawaii PPO	$605.28
Rate for Payer: University Health Alliance Commercial	$454.83

DRILL BIT CANNULATED, 11.0MM

Facility

$2,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,141.38
Max. Negotiated Rate	$2,170.86
Rate for Payer: Cash Price	$1,342.80
Rate for Payer: Hawaii Western Management Group Commercial	$2,126.10
Rate for Payer: Health Management Network Commercial	$1,902.30
Rate for Payer: Kaiser Permanente Commercial	$1,409.94
Rate for Payer: Kaiser Permanente Medicaid	$1,141.38
Rate for Payer: MDX Hawaii PPO	$2,170.86
Rate for Payer: University Health Alliance Commercial	$1,631.28

DRILL BIT CANNULATED, 11.0MM

Facility

$2,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,902.30
Max. Negotiated Rate	$2,170.86
Rate for Payer: Cash Price	$1,342.80
Rate for Payer: Health Management Network Commercial	$1,902.30
Rate for Payer: MDX Hawaii PPO	$2,170.86

DRILL BIT DRILL-2.4CL

Facility

$450.00

Hospital Revenue Code	272
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$436.50
Rate for Payer: Cash Price	$270.00
Rate for Payer: Hawaii Western Management Group Commercial	$427.50
Rate for Payer: Health Management Network Commercial	$382.50
Rate for Payer: Kaiser Permanente Commercial	$283.50
Rate for Payer: Kaiser Permanente Medicaid	$229.50
Rate for Payer: MDX Hawaii PPO	$436.50
Rate for Payer: University Health Alliance Commercial	$328.00

DRILL BIT DRILL-2.4CL

Facility

$450.00

Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$436.50
Rate for Payer: Cash Price	$270.00
Rate for Payer: Health Management Network Commercial	$382.50
Rate for Payer: MDX Hawaii PPO	$436.50

DRILL BIT FAST 2.0 231220204

Facility

$563.00

Hospital Revenue Code	272
Min. Negotiated Rate	$478.55
Max. Negotiated Rate	$546.11
Rate for Payer: Cash Price	$337.80
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: MDX Hawaii PPO	$546.11

DRILL BIT FAST 2.0 231220204

Facility

$563.00

Hospital Revenue Code	272
Min. Negotiated Rate	$287.13
Max. Negotiated Rate	$546.11
Rate for Payer: Cash Price	$337.80
Rate for Payer: Hawaii Western Management Group Commercial	$534.85
Rate for Payer: Health Management Network Commercial	$478.55
Rate for Payer: Kaiser Permanente Commercial	$354.69
Rate for Payer: Kaiser Permanente Medicaid	$287.13
Rate for Payer: MDX Hawaii PPO	$546.11
Rate for Payer: University Health Alliance Commercial	$410.37

DRILL BIT HOLLOW 10.0MM

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,368.50
Max. Negotiated Rate	$1,561.70
Rate for Payer: Cash Price	$966.00
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: MDX Hawaii PPO	$1,561.70

DRILL BIT HOLLOW 10.0MM

Facility

$1,610.00

Hospital Revenue Code	272
Min. Negotiated Rate	$821.10
Max. Negotiated Rate	$1,561.70
Rate for Payer: Cash Price	$966.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,529.50
Rate for Payer: Health Management Network Commercial	$1,368.50
Rate for Payer: Kaiser Permanente Commercial	$1,014.30
Rate for Payer: Kaiser Permanente Medicaid	$821.10
Rate for Payer: MDX Hawaii PPO	$1,561.70
Rate for Payer: University Health Alliance Commercial	$1,173.53

DRILL BIT JC 2.0X85MM 310.20

Facility

$372.00

Hospital Revenue Code	272
Min. Negotiated Rate	$189.72
Max. Negotiated Rate	$360.84
Rate for Payer: Cash Price	$223.20
Rate for Payer: Hawaii Western Management Group Commercial	$353.40
Rate for Payer: Health Management Network Commercial	$316.20
Rate for Payer: Kaiser Permanente Commercial	$234.36
Rate for Payer: Kaiser Permanente Medicaid	$189.72
Rate for Payer: MDX Hawaii PPO	$360.84
Rate for Payer: University Health Alliance Commercial	$271.15

DRILL BIT JC 2.0X85MM 310.20

Facility

$372.00

Hospital Revenue Code	272
Min. Negotiated Rate	$316.20
Max. Negotiated Rate	$360.84
Rate for Payer: Cash Price	$223.20
Rate for Payer: Health Management Network Commercial	$316.20
Rate for Payer: MDX Hawaii PPO	$360.84

DRILL BIT JC 2.5MM 4805-95-25

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$749.70
Max. Negotiated Rate	$855.54
Rate for Payer: Cash Price	$529.20
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: MDX Hawaii PPO	$855.54

DRILL BIT JC 2.5MM 4805-95-25

Facility

$882.00

Hospital Revenue Code	272
Min. Negotiated Rate	$449.82
Max. Negotiated Rate	$855.54
Rate for Payer: Cash Price	$529.20
Rate for Payer: Hawaii Western Management Group Commercial	$837.90
Rate for Payer: Health Management Network Commercial	$749.70
Rate for Payer: Kaiser Permanente Commercial	$555.66
Rate for Payer: Kaiser Permanente Medicaid	$449.82
Rate for Payer: MDX Hawaii PPO	$855.54
Rate for Payer: University Health Alliance Commercial	$642.89

DRILL BIT JC 4.5MM #03.010.089

Facility

$1,584.00

Hospital Revenue Code	272
Min. Negotiated Rate	$807.84
Max. Negotiated Rate	$1,536.48
Rate for Payer: Cash Price	$950.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,504.80
Rate for Payer: Health Management Network Commercial	$1,346.40
Rate for Payer: Kaiser Permanente Commercial	$997.92
Rate for Payer: Kaiser Permanente Medicaid	$807.84
Rate for Payer: MDX Hawaii PPO	$1,536.48
Rate for Payer: University Health Alliance Commercial	$1,154.58

DRILL BIT JC 4.5MM #03.010.089

Facility

$1,584.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.40
Max. Negotiated Rate	$1,536.48
Rate for Payer: Cash Price	$950.40
Rate for Payer: Health Management Network Commercial	$1,346.40
Rate for Payer: MDX Hawaii PPO	$1,536.48

Know your out-of-pocket cost for care.

All Charges