Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

EXCLUDER AAA 12X12 PLC121200

Facility

$11,204.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,274.24
Max. Negotiated Rate	$10,867.88
Rate for Payer: Cash Price	$6,722.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,842.80
Rate for Payer: Health Management Network Commercial	$9,523.40
Rate for Payer: MDX Hawaii PPO	$10,867.88
Rate for Payer: University Health Alliance Commercial	$6,274.24

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,828.06
Max. Negotiated Rate	$7,280.82
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: Kaiser Permanente Commercial	$4,728.78
Rate for Payer: Kaiser Permanente Medicaid	$3,828.06
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 16X10X7 PLL161007

Facility

$7,506.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,203.36
Max. Negotiated Rate	$7,280.82
Rate for Payer: Cash Price	$4,503.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,254.20
Rate for Payer: Health Management Network Commercial	$6,380.10
Rate for Payer: MDX Hawaii PPO	$7,280.82
Rate for Payer: University Health Alliance Commercial	$4,203.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$17,727.36
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA 23MM CXT231412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$16,144.56
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Kaiser Permanente Commercial	$19,943.28
Rate for Payer: Kaiser Permanente Medicaid	$16,144.56
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,102.04
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: Kaiser Permanente Commercial	$6,302.52
Rate for Payer: Kaiser Permanente Medicaid	$5,102.04
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA CXA200005

Facility

$10,004.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,602.24
Max. Negotiated Rate	$9,703.88
Rate for Payer: Cash Price	$6,002.40
Rate for Payer: Hawaii Western Management Group Commercial	$7,002.80
Rate for Payer: Health Management Network Commercial	$8,503.40
Rate for Payer: MDX Hawaii PPO	$9,703.88
Rate for Payer: University Health Alliance Commercial	$5,602.24

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA ENDOPRO PLC121400

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,885.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$7,270.20
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,801.60
Max. Negotiated Rate	$10,049.20
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161200

Facility

$10,360.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,283.60
Max. Negotiated Rate	$10,049.20
Rate for Payer: Cash Price	$6,216.00
Rate for Payer: Hawaii Western Management Group Commercial	$7,252.00
Rate for Payer: Health Management Network Commercial	$8,806.00
Rate for Payer: Kaiser Permanente Commercial	$6,526.80
Rate for Payer: Kaiser Permanente Medicaid	$5,283.60
Rate for Payer: MDX Hawaii PPO	$10,049.20
Rate for Payer: University Health Alliance Commercial	$5,801.60

EXCLUDER AAA PLL161407

Facility

$7,986.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,072.86
Max. Negotiated Rate	$7,746.42
Rate for Payer: Cash Price	$4,791.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,590.20
Rate for Payer: Health Management Network Commercial	$6,788.10
Rate for Payer: Kaiser Permanente Commercial	$5,031.18
Rate for Payer: Kaiser Permanente Medicaid	$4,072.86
Rate for Payer: MDX Hawaii PPO	$7,746.42
Rate for Payer: University Health Alliance Commercial	$4,472.16

EXCLUDER AAA PLL161407

Facility

$7,986.00

Hospital Revenue Code	278
Min. Negotiated Rate	$4,472.16
Max. Negotiated Rate	$7,746.42
Rate for Payer: Cash Price	$4,791.60
Rate for Payer: Hawaii Western Management Group Commercial	$5,590.20
Rate for Payer: Health Management Network Commercial	$6,788.10
Rate for Payer: MDX Hawaii PPO	$7,746.42
Rate for Payer: University Health Alliance Commercial	$4,472.16

EXCLUDER BIFURCATED ENDOPROSTH

Facility

$6,200.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,162.00
Max. Negotiated Rate	$6,014.00
Rate for Payer: Cash Price	$3,720.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,340.00
Rate for Payer: Health Management Network Commercial	$5,270.00
Rate for Payer: Kaiser Permanente Commercial	$3,906.00
Rate for Payer: Kaiser Permanente Medicaid	$3,162.00
Rate for Payer: MDX Hawaii PPO	$6,014.00
Rate for Payer: University Health Alliance Commercial	$3,472.00

EXCLUDER BIFURCATED ENDOPROSTH

Facility

$6,200.00

Hospital Revenue Code	278
Min. Negotiated Rate	$3,472.00
Max. Negotiated Rate	$6,014.00
Rate for Payer: Cash Price	$3,720.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,340.00
Rate for Payer: Health Management Network Commercial	$5,270.00
Rate for Payer: MDX Hawaii PPO	$6,014.00
Rate for Payer: University Health Alliance Commercial	$3,472.00

EXCLUDER COMFORMABLE CXT361414

Facility

$30,044.00

Hospital Revenue Code	278
Min. Negotiated Rate	$15,322.44
Max. Negotiated Rate	$29,142.68
Rate for Payer: Cash Price	$18,026.40
Rate for Payer: Hawaii Western Management Group Commercial	$21,030.80
Rate for Payer: Health Management Network Commercial	$25,537.40
Rate for Payer: Kaiser Permanente Commercial	$18,927.72
Rate for Payer: Kaiser Permanente Medicaid	$15,322.44
Rate for Payer: MDX Hawaii PPO	$29,142.68
Rate for Payer: University Health Alliance Commercial	$16,824.64

EXCLUDER COMFORMABLE CXT361414

Facility

$30,044.00

Hospital Revenue Code	278
Min. Negotiated Rate	$16,824.64
Max. Negotiated Rate	$29,142.68
Rate for Payer: Cash Price	$18,026.40
Rate for Payer: Hawaii Western Management Group Commercial	$21,030.80
Rate for Payer: Health Management Network Commercial	$25,537.40
Rate for Payer: MDX Hawaii PPO	$29,142.68
Rate for Payer: University Health Alliance Commercial	$16,824.64

EXCLUDER CONFORM AAA CXT281412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$17,727.36
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER CONFORM AAA CXT281412

Facility

$31,656.00

Hospital Revenue Code	278
Min. Negotiated Rate	$16,144.56
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$22,159.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Kaiser Permanente Commercial	$19,943.28
Rate for Payer: Kaiser Permanente Medicaid	$16,144.56
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$17,727.36

EXCLUDER CONFORM AAA CXT321414

Facility

$29,168.00

Hospital Revenue Code	278
Min. Negotiated Rate	$16,334.08
Max. Negotiated Rate	$28,292.96
Rate for Payer: Cash Price	$17,500.80
Rate for Payer: Hawaii Western Management Group Commercial	$20,417.60
Rate for Payer: Health Management Network Commercial	$24,792.80
Rate for Payer: MDX Hawaii PPO	$28,292.96
Rate for Payer: University Health Alliance Commercial	$16,334.08

EXCLUDER CONFORM AAA CXT321414

Facility

$29,168.00

Hospital Revenue Code	278
Min. Negotiated Rate	$14,875.68
Max. Negotiated Rate	$28,292.96
Rate for Payer: Cash Price	$17,500.80
Rate for Payer: Hawaii Western Management Group Commercial	$20,417.60
Rate for Payer: Health Management Network Commercial	$24,792.80
Rate for Payer: Kaiser Permanente Commercial	$18,375.84
Rate for Payer: Kaiser Permanente Medicaid	$14,875.68
Rate for Payer: MDX Hawaii PPO	$28,292.96
Rate for Payer: University Health Alliance Commercial	$16,334.08

EXCLUDER CONTRA LIMB PLC141200

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$5,885.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: Kaiser Permanente Commercial	$7,270.20
Rate for Payer: Kaiser Permanente Medicaid	$5,885.40
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER CONTRA LIMB PLC141200

Facility

$11,540.00

Hospital Revenue Code	278
Min. Negotiated Rate	$6,462.40
Max. Negotiated Rate	$11,193.80
Rate for Payer: Cash Price	$6,924.00
Rate for Payer: Hawaii Western Management Group Commercial	$8,078.00
Rate for Payer: Health Management Network Commercial	$9,809.00
Rate for Payer: MDX Hawaii PPO	$11,193.80
Rate for Payer: University Health Alliance Commercial	$6,462.40

EXCLUDER CXT261412

Facility

$31,656.00

Hospital Revenue Code	272
Min. Negotiated Rate	$26,907.60
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: MDX Hawaii PPO	$30,706.32

EXCLUDER CXT261412

Facility

$31,656.00

Hospital Revenue Code	272
Min. Negotiated Rate	$16,144.56
Max. Negotiated Rate	$30,706.32
Rate for Payer: Cash Price	$18,993.60
Rate for Payer: Hawaii Western Management Group Commercial	$30,073.20
Rate for Payer: Health Management Network Commercial	$26,907.60
Rate for Payer: Kaiser Permanente Commercial	$19,943.28
Rate for Payer: Kaiser Permanente Medicaid	$16,144.56
Rate for Payer: MDX Hawaii PPO	$30,706.32
Rate for Payer: University Health Alliance Commercial	$23,074.06

Know your out-of-pocket cost for care.

All Charges