Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT STRGHT SHANK 3.2X10

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

DRILL BIT STRGHT SHANK 3.2X10

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 3.5X10

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

DRILL BIT STRGHT SHANK 3.5X10

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 T-F 2.5MM 103.25.180

Facility

$1,050.00

Hospital Revenue Code	272
Min. Negotiated Rate	$892.50
Max. Negotiated Rate	$1,018.50
Rate for Payer: Cash Price	$630.00
Rate for Payer: Health Management Network Commercial	$892.50
Rate for Payer: MDX Hawaii PPO	$1,018.50

DRILL BIT T-F 2.5MM 103.25.180

Facility

$1,050.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$1,018.50
Rate for Payer: Cash Price	$630.00
Rate for Payer: Hawaii Western Management Group Commercial	$997.50
Rate for Payer: Health Management Network Commercial	$892.50
Rate for Payer: Kaiser Permanente Commercial	$661.50
Rate for Payer: Kaiser Permanente Medicaid	$535.50
Rate for Payer: MDX Hawaii PPO	$1,018.50
Rate for Payer: University Health Alliance Commercial	$765.35

DRILL CANN 13.0MM BIT 351.27

Facility

$2,058.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,049.58
Max. Negotiated Rate	$1,996.26
Rate for Payer: Cash Price	$1,234.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,955.10
Rate for Payer: Health Management Network Commercial	$1,749.30
Rate for Payer: Kaiser Permanente Commercial	$1,296.54
Rate for Payer: Kaiser Permanente Medicaid	$1,049.58
Rate for Payer: MDX Hawaii PPO	$1,996.26
Rate for Payer: University Health Alliance Commercial	$1,500.08

DRILL CANN 13.0MM BIT 351.27

Facility

$2,058.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,749.30
Max. Negotiated Rate	$1,996.26
Rate for Payer: Cash Price	$1,234.80
Rate for Payer: Health Management Network Commercial	$1,749.30
Rate for Payer: MDX Hawaii PPO	$1,996.26

DRILL CANN 15GA 60MM 308.151

Facility

$1,470.00

Hospital Revenue Code	272
Min. Negotiated Rate	$749.70
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,396.50
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: Kaiser Permanente Commercial	$926.10
Rate for Payer: Kaiser Permanente Medicaid	$749.70
Rate for Payer: MDX Hawaii PPO	$1,425.90
Rate for Payer: University Health Alliance Commercial	$1,071.48

DRILL CANN 15GA 60MM 308.151

Facility

$1,470.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$1,425.90
Rate for Payer: Cash Price	$882.00
Rate for Payer: Health Management Network Commercial	$1,249.50
Rate for Payer: MDX Hawaii PPO	$1,425.90

DRILL CANN 2.0MM DRILL-2.00CL

Facility

$581.00

Hospital Revenue Code	272
Min. Negotiated Rate	$493.85
Max. Negotiated Rate	$563.57
Rate for Payer: Cash Price	$348.60
Rate for Payer: Health Management Network Commercial	$493.85
Rate for Payer: MDX Hawaii PPO	$563.57

DRILL CANN 2.0MM DRILL-2.00CL

Facility

$581.00

Hospital Revenue Code	272
Min. Negotiated Rate	$296.31
Max. Negotiated Rate	$563.57
Rate for Payer: Cash Price	$348.60
Rate for Payer: Hawaii Western Management Group Commercial	$551.95
Rate for Payer: Health Management Network Commercial	$493.85
Rate for Payer: Kaiser Permanente Commercial	$366.03
Rate for Payer: Kaiser Permanente Medicaid	$296.31
Rate for Payer: MDX Hawaii PPO	$563.57
Rate for Payer: University Health Alliance Commercial	$423.49

DRILL CANN 3.20MM DRILL-3.20CL

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$321.30
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Hawaii Western Management Group Commercial	$598.50
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: Kaiser Permanente Commercial	$396.90
Rate for Payer: Kaiser Permanente Medicaid	$321.30
Rate for Payer: MDX Hawaii PPO	$611.10
Rate for Payer: University Health Alliance Commercial	$459.21

DRILL CANN 3.20MM DRILL-3.20CL

Facility

$630.00

Hospital Revenue Code	272
Min. Negotiated Rate	$535.50
Max. Negotiated Rate	$611.10
Rate for Payer: Cash Price	$378.00
Rate for Payer: Health Management Network Commercial	$535.50
Rate for Payer: MDX Hawaii PPO	$611.10

DRILL CANN 3.2MMX170MM 310.65

Facility

$1,565.00

Hospital Revenue Code	272
Min. Negotiated Rate	$798.15
Max. Negotiated Rate	$1,518.05
Rate for Payer: Cash Price	$939.00
Rate for Payer: Hawaii Western Management Group Commercial	$1,486.75
Rate for Payer: Health Management Network Commercial	$1,330.25
Rate for Payer: Kaiser Permanente Commercial	$985.95
Rate for Payer: Kaiser Permanente Medicaid	$798.15
Rate for Payer: MDX Hawaii PPO	$1,518.05
Rate for Payer: University Health Alliance Commercial	$1,140.73

DRILL CANN 3.2MMX170MM 310.65

Facility

$1,565.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,330.25
Max. Negotiated Rate	$1,518.05
Rate for Payer: Cash Price	$939.00
Rate for Payer: Health Management Network Commercial	$1,330.25
Rate for Payer: MDX Hawaii PPO	$1,518.05

DRILL CANN QR 2.3MM 316-0015

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$747.15
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: MDX Hawaii PPO	$852.63

DRILL CANN QR 2.3MM 316-0015

Facility

$879.00

Hospital Revenue Code	272
Min. Negotiated Rate	$448.29
Max. Negotiated Rate	$852.63
Rate for Payer: Cash Price	$527.40
Rate for Payer: Hawaii Western Management Group Commercial	$835.05
Rate for Payer: Health Management Network Commercial	$747.15
Rate for Payer: Kaiser Permanente Commercial	$553.77
Rate for Payer: Kaiser Permanente Medicaid	$448.29
Rate for Payer: MDX Hawaii PPO	$852.63
Rate for Payer: University Health Alliance Commercial	$640.70

DRILL CANNULATED 2.5MM

Facility

$1,022.00

Hospital Revenue Code	272
Min. Negotiated Rate	$521.22
Max. Negotiated Rate	$991.34
Rate for Payer: Cash Price	$613.20
Rate for Payer: Hawaii Western Management Group Commercial	$970.90
Rate for Payer: Health Management Network Commercial	$868.70
Rate for Payer: Kaiser Permanente Commercial	$643.86
Rate for Payer: Kaiser Permanente Medicaid	$521.22
Rate for Payer: MDX Hawaii PPO	$991.34
Rate for Payer: University Health Alliance Commercial	$744.94

DRILL CANNULATED 2.5MM

Facility

$1,022.00

Hospital Revenue Code	272
Min. Negotiated Rate	$868.70
Max. Negotiated Rate	$991.34
Rate for Payer: Cash Price	$613.20
Rate for Payer: Health Management Network Commercial	$868.70
Rate for Payer: MDX Hawaii PPO	$991.34

DRILL CANNULATED DRILL-2.0/110

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: MDX Hawaii PPO	$800.25

DRILL CANNULATED DRILL-2.0/110

Facility

$825.00

Hospital Revenue Code	272
Min. Negotiated Rate	$420.75
Max. Negotiated Rate	$800.25
Rate for Payer: Cash Price	$495.00
Rate for Payer: Hawaii Western Management Group Commercial	$783.75
Rate for Payer: Health Management Network Commercial	$701.25
Rate for Payer: Kaiser Permanente Commercial	$519.75
Rate for Payer: Kaiser Permanente Medicaid	$420.75
Rate for Payer: MDX Hawaii PPO	$800.25
Rate for Payer: University Health Alliance Commercial	$601.34

DRILL COUNTERSINK 2.7MM 706200

Facility

$826.00

Hospital Revenue Code	272
Min. Negotiated Rate	$421.26
Max. Negotiated Rate	$801.22
Rate for Payer: Cash Price	$495.60
Rate for Payer: Hawaii Western Management Group Commercial	$784.70
Rate for Payer: Health Management Network Commercial	$702.10
Rate for Payer: Kaiser Permanente Commercial	$520.38
Rate for Payer: Kaiser Permanente Medicaid	$421.26
Rate for Payer: MDX Hawaii PPO	$801.22
Rate for Payer: University Health Alliance Commercial	$602.07

DRILL COUNTERSINK 2.7MM 706200

Facility

$826.00

Hospital Revenue Code	272
Min. Negotiated Rate	$702.10
Max. Negotiated Rate	$801.22
Rate for Payer: Cash Price	$495.60
Rate for Payer: Health Management Network Commercial	$702.10
Rate for Payer: MDX Hawaii PPO	$801.22

DRILL FREEHAND 2351-4218S

Facility

$1,096.00

Hospital Revenue Code	272
Min. Negotiated Rate	$931.60
Max. Negotiated Rate	$1,063.12
Rate for Payer: Cash Price	$657.60
Rate for Payer: Health Management Network Commercial	$931.60
Rate for Payer: MDX Hawaii PPO	$1,063.12

Know your out-of-pocket cost for care.

All Charges