Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT QC 2.7X160MM 310.67

Facility

$1,545.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,313.25
Max. Negotiated Rate	$1,498.65
Rate for Payer: Cash Price	$927.00
Rate for Payer: Health Management Network Commercial	$1,313.25
Rate for Payer: MDX Hawaii PPO	$1,498.65

DRILL BIT QC 2.8X165MM 310.288

Facility

$406.00

Hospital Revenue Code	272
Min. Negotiated Rate	$345.10
Max. Negotiated Rate	$393.82
Rate for Payer: Cash Price	$243.60
Rate for Payer: Health Management Network Commercial	$345.10
Rate for Payer: MDX Hawaii PPO	$393.82

DRILL BIT QC 2.8X165MM 310.288

Facility

$406.00

Hospital Revenue Code	272
Min. Negotiated Rate	$207.06
Max. Negotiated Rate	$393.82
Rate for Payer: Cash Price	$243.60
Rate for Payer: Hawaii Western Management Group Commercial	$385.70
Rate for Payer: Health Management Network Commercial	$345.10
Rate for Payer: Kaiser Permanente Commercial	$255.78
Rate for Payer: Kaiser Permanente Medicaid	$207.06
Rate for Payer: MDX Hawaii PPO	$393.82
Rate for Payer: University Health Alliance Commercial	$295.93

DRILL BIT QC 2.8X200MM 324.214

Facility

$815.00

Hospital Revenue Code	272
Min. Negotiated Rate	$692.75
Max. Negotiated Rate	$790.55
Rate for Payer: Cash Price	$489.00
Rate for Payer: Health Management Network Commercial	$692.75
Rate for Payer: MDX Hawaii PPO	$790.55

DRILL BIT QC 2.8X200MM 324.214

Facility

$815.00

Hospital Revenue Code	272
Min. Negotiated Rate	$415.65
Max. Negotiated Rate	$790.55
Rate for Payer: Cash Price	$489.00
Rate for Payer: Hawaii Western Management Group Commercial	$774.25
Rate for Payer: Health Management Network Commercial	$692.75
Rate for Payer: Kaiser Permanente Commercial	$513.45
Rate for Payer: Kaiser Permanente Medicaid	$415.65
Rate for Payer: MDX Hawaii PPO	$790.55
Rate for Payer: University Health Alliance Commercial	$594.05

DRILL BIT QC 2.9X150MM 310.229

Facility

$514.00

Hospital Revenue Code	272
Min. Negotiated Rate	$262.14
Max. Negotiated Rate	$498.58
Rate for Payer: Cash Price	$308.40
Rate for Payer: Hawaii Western Management Group Commercial	$488.30
Rate for Payer: Health Management Network Commercial	$436.90
Rate for Payer: Kaiser Permanente Commercial	$323.82
Rate for Payer: Kaiser Permanente Medicaid	$262.14
Rate for Payer: MDX Hawaii PPO	$498.58
Rate for Payer: University Health Alliance Commercial	$374.65

DRILL BIT QC 2.9X150MM 310.229

Facility

$514.00

Hospital Revenue Code	272
Min. Negotiated Rate	$436.90
Max. Negotiated Rate	$498.58
Rate for Payer: Cash Price	$308.40
Rate for Payer: Health Management Network Commercial	$436.90
Rate for Payer: MDX Hawaii PPO	$498.58

DRILL BIT QC 3.2X145MM 310.31

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 QC 3.2X145MM 310.31

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 QC 3.5X110MM 310.35

Facility

$373.00

Hospital Revenue Code	272
Min. Negotiated Rate	$317.05
Max. Negotiated Rate	$361.81
Rate for Payer: Cash Price	$223.80
Rate for Payer: Health Management Network Commercial	$317.05
Rate for Payer: MDX Hawaii PPO	$361.81

DRILL BIT QC 3.5X110MM 310.35

Facility

$373.00

Hospital Revenue Code	272
Min. Negotiated Rate	$190.23
Max. Negotiated Rate	$361.81
Rate for Payer: Cash Price	$223.80
Rate for Payer: Hawaii Western Management Group Commercial	$354.35
Rate for Payer: Health Management Network Commercial	$317.05
Rate for Payer: Kaiser Permanente Commercial	$234.99
Rate for Payer: Kaiser Permanente Medicaid	$190.23
Rate for Payer: MDX Hawaii PPO	$361.81
Rate for Payer: University Health Alliance Commercial	$271.88

DRILL BIT QC 3.5X195MM #310.37

Facility

$385.00

Hospital Revenue Code	272
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$373.45
Rate for Payer: Cash Price	$231.00
Rate for Payer: Health Management Network Commercial	$327.25
Rate for Payer: MDX Hawaii PPO	$373.45

DRILL BIT QC 3.5X195MM #310.37

Facility

$385.00

Hospital Revenue Code	272
Min. Negotiated Rate	$196.35
Max. Negotiated Rate	$373.45
Rate for Payer: Cash Price	$231.00
Rate for Payer: Hawaii Western Management Group Commercial	$365.75
Rate for Payer: Health Management Network Commercial	$327.25
Rate for Payer: Kaiser Permanente Commercial	$242.55
Rate for Payer: Kaiser Permanente Medicaid	$196.35
Rate for Payer: MDX Hawaii PPO	$373.45
Rate for Payer: University Health Alliance Commercial	$280.63

DRILL BIT QC 3.8MMX270MM

Facility

$1,194.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,014.90
Max. Negotiated Rate	$1,158.18
Rate for Payer: Cash Price	$716.40
Rate for Payer: Health Management Network Commercial	$1,014.90
Rate for Payer: MDX Hawaii PPO	$1,158.18

DRILL BIT QC 3.8MMX270MM

Facility

$1,194.00

Hospital Revenue Code	272
Min. Negotiated Rate	$608.94
Max. Negotiated Rate	$1,158.18
Rate for Payer: Cash Price	$716.40
Rate for Payer: Hawaii Western Management Group Commercial	$1,134.30
Rate for Payer: Health Management Network Commercial	$1,014.90
Rate for Payer: Kaiser Permanente Commercial	$752.22
Rate for Payer: Kaiser Permanente Medicaid	$608.94
Rate for Payer: MDX Hawaii PPO	$1,158.18
Rate for Payer: University Health Alliance Commercial	$870.31

DRILL BIT QC 4.3X180MM 310.431

Facility

$554.00

Hospital Revenue Code	272
Min. Negotiated Rate	$282.54
Max. Negotiated Rate	$537.38
Rate for Payer: Cash Price	$332.40
Rate for Payer: Hawaii Western Management Group Commercial	$526.30
Rate for Payer: Health Management Network Commercial	$470.90
Rate for Payer: Kaiser Permanente Commercial	$349.02
Rate for Payer: Kaiser Permanente Medicaid	$282.54
Rate for Payer: MDX Hawaii PPO	$537.38
Rate for Payer: University Health Alliance Commercial	$403.81

DRILL BIT QC 4.3X180MM 310.431

Facility

$554.00

Hospital Revenue Code	272
Min. Negotiated Rate	$470.90
Max. Negotiated Rate	$537.38
Rate for Payer: Cash Price	$332.40
Rate for Payer: Health Management Network Commercial	$470.90
Rate for Payer: MDX Hawaii PPO	$537.38

DRILL BIT QC 4.3X200MM 310.634

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,250.35
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: MDX Hawaii PPO	$1,426.87

DRILL BIT QC 4.3X200MM 310.634

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$750.21
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,397.45
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Kaiser Permanente Commercial	$926.73
Rate for Payer: Kaiser Permanente Medicaid	$750.21
Rate for Payer: MDX Hawaii PPO	$1,426.87
Rate for Payer: University Health Alliance Commercial	$1,072.21

DRILL BIT QC 5.0X200MM 310.632

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,250.35
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: MDX Hawaii PPO	$1,426.87

DRILL BIT QC 5.0X200MM 310.632

Facility

$1,471.00

Hospital Revenue Code	272
Min. Negotiated Rate	$750.21
Max. Negotiated Rate	$1,426.87
Rate for Payer: Cash Price	$882.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,397.45
Rate for Payer: Health Management Network Commercial	$1,250.35
Rate for Payer: Kaiser Permanente Commercial	$926.73
Rate for Payer: Kaiser Permanente Medicaid	$750.21
Rate for Payer: MDX Hawaii PPO	$1,426.87
Rate for Payer: University Health Alliance Commercial	$1,072.21

DRILL BIT QC 5.0X300MM 310.63

Facility

$1,575.00

Hospital Revenue Code	272
Min. Negotiated Rate	$803.25
Max. Negotiated Rate	$1,527.75
Rate for Payer: Cash Price	$945.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,496.25
Rate for Payer: Health Management Network Commercial	$1,338.75
Rate for Payer: Kaiser Permanente Commercial	$992.25
Rate for Payer: Kaiser Permanente Medicaid	$803.25
Rate for Payer: MDX Hawaii PPO	$1,527.75
Rate for Payer: University Health Alliance Commercial	$1,148.02

DRILL BIT QC 5.0X300MM 310.63

Facility

$1,575.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,338.75
Max. Negotiated Rate	$1,527.75
Rate for Payer: Cash Price	$945.00
Rate for Payer: Health Management Network Commercial	$1,338.75
Rate for Payer: MDX Hawaii PPO	$1,527.75

DRILL BIT, STRGHT SHANK 2.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$171.70
Max. Negotiated Rate	$195.94
Rate for Payer: Cash Price	$121.20
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: MDX Hawaii PPO	$195.94

DRILL BIT, STRGHT SHANK 2.5X10

Facility

$202.00

Hospital Revenue Code	272
Min. Negotiated Rate	$103.02
Max. Negotiated Rate	$195.94
Rate for Payer: Cash Price	$121.20
Rate for Payer: Hawaii Western Management Group Commercial	$191.90
Rate for Payer: Health Management Network Commercial	$171.70
Rate for Payer: Kaiser Permanente Commercial	$127.26
Rate for Payer: Kaiser Permanente Medicaid	$103.02
Rate for Payer: MDX Hawaii PPO	$195.94
Rate for Payer: University Health Alliance Commercial	$147.24

Know your out-of-pocket cost for care.

All Charges