Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

ELECTRODE BALL

Facility

$90.00

Hospital Revenue Code	272
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$54.00
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: MDX Hawaii PPO	$87.30

ELECTRODE BALL 3X11CM

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$47.94
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Hawaii Western Management Group Commercial	$89.30
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$59.22
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: University Health Alliance Commercial	$68.52

ELECTRODE BALL 3X11CM

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: MDX Hawaii PPO	$91.18

ELECTRODE BUTTON 24FR

Facility

$1,568.00

Hospital Revenue Code	272
Min. Negotiated Rate	$799.68
Max. Negotiated Rate	$1,520.96
Rate for Payer: Cash Price	$940.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,489.60
Rate for Payer: Health Management Network Commercial	$1,332.80
Rate for Payer: Kaiser Permanente Commercial	$987.84
Rate for Payer: Kaiser Permanente Medicaid	$799.68
Rate for Payer: MDX Hawaii PPO	$1,520.96
Rate for Payer: University Health Alliance Commercial	$1,142.92

ELECTRODE BUTTON 24FR

Facility

$1,568.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,332.80
Max. Negotiated Rate	$1,520.96
Rate for Payer: Cash Price	$940.80
Rate for Payer: Health Management Network Commercial	$1,332.80
Rate for Payer: MDX Hawaii PPO	$1,520.96

ELECTRODE ELECTROSURGICAL 24F

Facility

$1,501.00

Hospital Revenue Code	272
Min. Negotiated Rate	$765.51
Max. Negotiated Rate	$1,455.97
Rate for Payer: Cash Price	$900.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,425.95
Rate for Payer: Health Management Network Commercial	$1,275.85
Rate for Payer: Kaiser Permanente Commercial	$945.63
Rate for Payer: Kaiser Permanente Medicaid	$765.51
Rate for Payer: MDX Hawaii PPO	$1,455.97
Rate for Payer: University Health Alliance Commercial	$1,094.08

ELECTRODE ELECTROSURGICAL 24F

Facility

$1,501.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,275.85
Max. Negotiated Rate	$1,455.97
Rate for Payer: Cash Price	$900.60
Rate for Payer: Health Management Network Commercial	$1,275.85
Rate for Payer: MDX Hawaii PPO	$1,455.97

ELECTRODE LOOP 10x10MM DLP-S11

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: MDX Hawaii PPO	$91.18

ELECTRODE LOOP 10x10MM DLP-S11

Facility

$94.00

Hospital Revenue Code	272
Min. Negotiated Rate	$47.94
Max. Negotiated Rate	$91.18
Rate for Payer: Cash Price	$56.40
Rate for Payer: Hawaii Western Management Group Commercial	$89.30
Rate for Payer: Health Management Network Commercial	$79.90
Rate for Payer: Kaiser Permanente Commercial	$59.22
Rate for Payer: Kaiser Permanente Medicaid	$47.94
Rate for Payer: MDX Hawaii PPO	$91.18
Rate for Payer: University Health Alliance Commercial	$68.52

ELECTRODE LOOP 15MM X 12MM

Facility

$90.00

Hospital Revenue Code	272
Min. Negotiated Rate	$45.90
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$54.00
Rate for Payer: Hawaii Western Management Group Commercial	$85.50
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: Kaiser Permanente Commercial	$56.70
Rate for Payer: Kaiser Permanente Medicaid	$45.90
Rate for Payer: MDX Hawaii PPO	$87.30
Rate for Payer: University Health Alliance Commercial	$65.60

ELECTRODE LOOP 15MM X 12MM

Facility

$90.00

Hospital Revenue Code	272
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$87.30
Rate for Payer: Cash Price	$54.00
Rate for Payer: Health Management Network Commercial	$76.50
Rate for Payer: MDX Hawaii PPO	$87.30

ELECTRODE SEALER DIVIDER

Facility

$1,063.00

Hospital Revenue Code	272
Min. Negotiated Rate	$903.55
Max. Negotiated Rate	$1,031.11
Rate for Payer: Cash Price	$637.80
Rate for Payer: Health Management Network Commercial	$903.55
Rate for Payer: MDX Hawaii PPO	$1,031.11

ELECTRODE SEALER DIVIDER

Facility

$1,063.00

Hospital Revenue Code	272
Min. Negotiated Rate	$542.13
Max. Negotiated Rate	$1,031.11
Rate for Payer: Cash Price	$637.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,009.85
Rate for Payer: Health Management Network Commercial	$903.55
Rate for Payer: Kaiser Permanente Commercial	$669.69
Rate for Payer: Kaiser Permanente Medicaid	$542.13
Rate for Payer: MDX Hawaii PPO	$1,031.11
Rate for Payer: University Health Alliance Commercial	$774.82

ELECTROD PAIRED SUBDERMAL

Facility

$540.00

Hospital Revenue Code	272
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$523.80
Rate for Payer: Cash Price	$324.00
Rate for Payer: Health Management Network Commercial	$459.00
Rate for Payer: MDX Hawaii PPO	$523.80

ELECTROD PAIRED SUBDERMAL

Facility

$540.00

Hospital Revenue Code	272
Min. Negotiated Rate	$275.40
Max. Negotiated Rate	$523.80
Rate for Payer: Cash Price	$324.00
Rate for Payer: Hawaii Western Management Group Commercial	$513.00
Rate for Payer: Health Management Network Commercial	$459.00
Rate for Payer: Kaiser Permanente Commercial	$340.20
Rate for Payer: Kaiser Permanente Medicaid	$275.40
Rate for Payer: MDX Hawaii PPO	$523.80
Rate for Payer: University Health Alliance Commercial	$393.61

ELECTROD PLASMA RESECTION LOOP

Facility

$1,501.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,275.85
Max. Negotiated Rate	$1,455.97
Rate for Payer: Cash Price	$900.60
Rate for Payer: Health Management Network Commercial	$1,275.85
Rate for Payer: MDX Hawaii PPO	$1,455.97

ELECTROD PLASMA RESECTION LOOP

Facility

$1,501.00

Hospital Revenue Code	272
Min. Negotiated Rate	$765.51
Max. Negotiated Rate	$1,455.97
Rate for Payer: Cash Price	$900.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,425.95
Rate for Payer: Health Management Network Commercial	$1,275.85
Rate for Payer: Kaiser Permanente Commercial	$945.63
Rate for Payer: Kaiser Permanente Medicaid	$765.51
Rate for Payer: MDX Hawaii PPO	$1,455.97
Rate for Payer: University Health Alliance Commercial	$1,094.08

ELECTROD PRASS EMG 18MM

Facility

$698.00

Hospital Revenue Code	270
Min. Negotiated Rate	$355.98
Max. Negotiated Rate	$677.06
Rate for Payer: Cash Price	$418.80
Rate for Payer: Hawaii Western Management Group Commercial	$663.10
Rate for Payer: Health Management Network Commercial	$593.30
Rate for Payer: Kaiser Permanente Commercial	$439.74
Rate for Payer: Kaiser Permanente Medicaid	$355.98
Rate for Payer: MDX Hawaii PPO	$677.06
Rate for Payer: University Health Alliance Commercial	$508.77

ELECTROD PRASS EMG 18MM

Facility

$698.00

Hospital Revenue Code	270
Min. Negotiated Rate	$593.30
Max. Negotiated Rate	$677.06
Rate for Payer: Cash Price	$418.80
Rate for Payer: Health Management Network Commercial	$593.30
Rate for Payer: MDX Hawaii PPO	$677.06

ELECTROD PROBE 4PRD ROHS

Facility

$814.00

Hospital Revenue Code	272
Min. Negotiated Rate	$691.90
Max. Negotiated Rate	$789.58
Rate for Payer: Cash Price	$488.40
Rate for Payer: Health Management Network Commercial	$691.90
Rate for Payer: MDX Hawaii PPO	$789.58

ELECTROD PROBE 4PRD ROHS

Facility

$814.00

Hospital Revenue Code	272
Min. Negotiated Rate	$415.14
Max. Negotiated Rate	$789.58
Rate for Payer: Cash Price	$488.40
Rate for Payer: Hawaii Western Management Group Commercial	$773.30
Rate for Payer: Health Management Network Commercial	$691.90
Rate for Payer: Kaiser Permanente Commercial	$512.82
Rate for Payer: Kaiser Permanente Medicaid	$415.14
Rate for Payer: MDX Hawaii PPO	$789.58
Rate for Payer: University Health Alliance Commercial	$593.32

ELECTROD WAND COBLATION

Facility

$1,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$1,052.30
Max. Negotiated Rate	$1,200.86
Rate for Payer: Cash Price	$742.80
Rate for Payer: Health Management Network Commercial	$1,052.30
Rate for Payer: MDX Hawaii PPO	$1,200.86

ELECTROD WAND COBLATION

Facility

$1,238.00

Hospital Revenue Code	272
Min. Negotiated Rate	$631.38
Max. Negotiated Rate	$1,200.86
Rate for Payer: Cash Price	$742.80
Rate for Payer: Hawaii Western Management Group Commercial	$1,176.10
Rate for Payer: Health Management Network Commercial	$1,052.30
Rate for Payer: Kaiser Permanente Commercial	$779.94
Rate for Payer: Kaiser Permanente Medicaid	$631.38
Rate for Payer: MDX Hawaii PPO	$1,200.86
Rate for Payer: University Health Alliance Commercial	$902.38

ELECTRO LUBE STERILE EL-101

Facility

$150.00

Hospital Revenue Code	272
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$90.00
Rate for Payer: Hawaii Western Management Group Commercial	$142.50
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: Kaiser Permanente Commercial	$94.50
Rate for Payer: Kaiser Permanente Medicaid	$76.50
Rate for Payer: MDX Hawaii PPO	$145.50
Rate for Payer: University Health Alliance Commercial	$109.33

ELECTRO LUBE STERILE EL-101

Facility

$150.00

Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$145.50
Rate for Payer: Cash Price	$90.00
Rate for Payer: Health Management Network Commercial	$127.50
Rate for Payer: MDX Hawaii PPO	$145.50

Know your out-of-pocket cost for care.

All Charges