Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$58,747.99

Service Code	MSDRG 755
Min. Negotiated Rate	$12,372.91
Max. Negotiated Rate	$58,747.99
Rate for Payer: AlohaCare Medicare	$12,372.91
Rate for Payer: Devoted Health Medicare	$13,610.20
Rate for Payer: Hawaii Medical Service Association Commercial	$58,747.99
Rate for Payer: Hawaii Medical Service Association Medicare	$12,372.91
Rate for Payer: Humana Medicare	$12,372.91
Rate for Payer: Kaiser Permanente Commercial	$18,764.55
Rate for Payer: Kaiser Permanente Medicare	$12,372.91
Rate for Payer: Ohana Health Plan Medicare	$12,372.91
Rate for Payer: UnitedHealthcare Medicare	$12,372.91

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$58,747.99

Service Code	MSDRG 754
Min. Negotiated Rate	$20,947.96
Max. Negotiated Rate	$58,747.99
Rate for Payer: AlohaCare Medicare	$20,947.96
Rate for Payer: Devoted Health Medicare	$23,042.76
Rate for Payer: Hawaii Medical Service Association Commercial	$58,747.99
Rate for Payer: Hawaii Medical Service Association Medicare	$20,947.96
Rate for Payer: Humana Medicare	$20,947.96
Rate for Payer: Kaiser Permanente Commercial	$31,769.33
Rate for Payer: Kaiser Permanente Medicare	$20,947.96
Rate for Payer: Ohana Health Plan Medicare	$20,947.96
Rate for Payer: UnitedHealthcare Medicare	$20,947.96

MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$22,057.79

Service Code	MSDRG 756
Min. Negotiated Rate	$10,924.95
Max. Negotiated Rate	$22,057.79
Rate for Payer: AlohaCare Medicare	$10,924.95
Rate for Payer: Devoted Health Medicare	$12,017.44
Rate for Payer: Hawaii Medical Service Association Commercial	$22,057.79
Rate for Payer: Hawaii Medical Service Association Medicare	$10,924.95
Rate for Payer: Humana Medicare	$10,924.95
Rate for Payer: Kaiser Permanente Commercial	$16,568.62
Rate for Payer: Kaiser Permanente Medicare	$10,924.95
Rate for Payer: Ohana Health Plan Medicare	$10,924.95
Rate for Payer: UnitedHealthcare Medicare	$10,924.95

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$3,627.96

Service Code	APR-DRG 5002
Min. Negotiated Rate	$3,627.96
Max. Negotiated Rate	$3,627.96
Rate for Payer: AlohaCare Medicaid	$3,627.96
Rate for Payer: Hawaii Medical Service Association ABD	$3,627.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,627.96
Rate for Payer: Kaiser Permanente Medicaid	$3,627.96
Rate for Payer: Ohana Health Plan Medicaid	$3,627.96
Rate for Payer: UnitedHealthcare Medicaid	$3,627.96

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$5,244.96

Service Code	APR-DRG 5003
Min. Negotiated Rate	$5,244.96
Max. Negotiated Rate	$5,244.96
Rate for Payer: AlohaCare Medicaid	$5,244.96
Rate for Payer: Hawaii Medical Service Association ABD	$5,244.96
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,244.96
Rate for Payer: Kaiser Permanente Medicaid	$5,244.96
Rate for Payer: Ohana Health Plan Medicaid	$5,244.96
Rate for Payer: UnitedHealthcare Medicaid	$5,244.96

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$8,096.71

Service Code	APR-DRG 5004
Min. Negotiated Rate	$8,096.71
Max. Negotiated Rate	$8,096.71
Rate for Payer: AlohaCare Medicaid	$8,096.71
Rate for Payer: Hawaii Medical Service Association ABD	$8,096.71
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,096.71
Rate for Payer: Kaiser Permanente Medicaid	$8,096.71
Rate for Payer: Ohana Health Plan Medicaid	$8,096.71
Rate for Payer: UnitedHealthcare Medicaid	$8,096.71

MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$2,883.72

Service Code	APR-DRG 5001
Min. Negotiated Rate	$2,883.72
Max. Negotiated Rate	$2,883.72
Rate for Payer: AlohaCare Medicaid	$2,883.72
Rate for Payer: Hawaii Medical Service Association ABD	$2,883.72
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,883.72
Rate for Payer: Kaiser Permanente Medicaid	$2,883.72
Rate for Payer: Ohana Health Plan Medicaid	$2,883.72
Rate for Payer: UnitedHealthcare Medicaid	$2,883.72

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC

Facility

$44,382.51

Service Code	MSDRG 723
Min. Negotiated Rate	$12,997.35
Max. Negotiated Rate	$44,382.51
Rate for Payer: AlohaCare Medicare	$12,997.35
Rate for Payer: Devoted Health Medicare	$14,297.08
Rate for Payer: Hawaii Medical Service Association Commercial	$44,382.51
Rate for Payer: Hawaii Medical Service Association Medicare	$12,997.35
Rate for Payer: Humana Medicare	$12,997.35
Rate for Payer: Kaiser Permanente Commercial	$19,711.58
Rate for Payer: Kaiser Permanente Medicare	$12,997.35
Rate for Payer: Ohana Health Plan Medicare	$12,997.35
Rate for Payer: UnitedHealthcare Medicare	$12,997.35

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$44,382.51

Service Code	MSDRG 722
Min. Negotiated Rate	$20,584.00
Max. Negotiated Rate	$44,382.51
Rate for Payer: AlohaCare Medicare	$20,584.00
Rate for Payer: Devoted Health Medicare	$22,642.40
Rate for Payer: Hawaii Medical Service Association Commercial	$44,382.51
Rate for Payer: Hawaii Medical Service Association Medicare	$20,584.00
Rate for Payer: Humana Medicare	$20,584.00
Rate for Payer: Kaiser Permanente Commercial	$31,217.33
Rate for Payer: Kaiser Permanente Medicare	$20,584.00
Rate for Payer: Ohana Health Plan Medicare	$20,584.00
Rate for Payer: UnitedHealthcare Medicare	$20,584.00

MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$30,866.35

Service Code	MSDRG 724
Min. Negotiated Rate	$7,458.10
Max. Negotiated Rate	$30,866.35
Rate for Payer: AlohaCare Medicare	$7,458.10
Rate for Payer: Devoted Health Medicare	$8,203.91
Rate for Payer: Hawaii Medical Service Association Commercial	$30,866.35
Rate for Payer: Hawaii Medical Service Association Medicare	$7,458.10
Rate for Payer: Humana Medicare	$7,458.10
Rate for Payer: Kaiser Permanente Commercial	$10,551.83
Rate for Payer: Kaiser Permanente Medicare	$7,458.10
Rate for Payer: Ohana Health Plan Medicare	$7,458.10
Rate for Payer: UnitedHealthcare Medicare	$7,458.10

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC

Facility

$39,553.58

Service Code	MSDRG 436
Min. Negotiated Rate	$12,865.43
Max. Negotiated Rate	$39,553.58
Rate for Payer: AlohaCare Medicare	$12,865.43
Rate for Payer: Devoted Health Medicare	$14,151.97
Rate for Payer: Hawaii Medical Service Association Commercial	$39,553.58
Rate for Payer: Hawaii Medical Service Association Medicare	$12,865.43
Rate for Payer: Humana Medicare	$12,865.43
Rate for Payer: Kaiser Permanente Commercial	$19,511.47
Rate for Payer: Kaiser Permanente Medicare	$12,865.43
Rate for Payer: Ohana Health Plan Medicare	$12,865.43
Rate for Payer: UnitedHealthcare Medicare	$12,865.43

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC

Facility

$39,553.58

Service Code	MSDRG 435
Min. Negotiated Rate	$20,891.10
Max. Negotiated Rate	$39,553.58
Rate for Payer: AlohaCare Medicare	$20,891.10
Rate for Payer: Devoted Health Medicare	$22,980.21
Rate for Payer: Hawaii Medical Service Association Commercial	$39,553.58
Rate for Payer: Hawaii Medical Service Association Medicare	$20,891.10
Rate for Payer: Humana Medicare	$20,891.10
Rate for Payer: Kaiser Permanente Commercial	$31,683.08
Rate for Payer: Kaiser Permanente Medicare	$20,891.10
Rate for Payer: Ohana Health Plan Medicare	$20,891.10
Rate for Payer: UnitedHealthcare Medicare	$20,891.10

MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC

Facility

$39,553.58

Service Code	MSDRG 437
Min. Negotiated Rate	$9,705.66
Max. Negotiated Rate	$39,553.58
Rate for Payer: AlohaCare Medicare	$9,705.66
Rate for Payer: Devoted Health Medicare	$10,676.23
Rate for Payer: Hawaii Medical Service Association Commercial	$39,553.58
Rate for Payer: Hawaii Medical Service Association Medicare	$9,705.66
Rate for Payer: Humana Medicare	$9,705.66
Rate for Payer: Kaiser Permanente Commercial	$14,719.42
Rate for Payer: Kaiser Permanente Medicare	$9,705.66
Rate for Payer: Ohana Health Plan Medicare	$9,705.66
Rate for Payer: UnitedHealthcare Medicare	$9,705.66

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$5,691.12

Service Code	APR-DRG 2813
Min. Negotiated Rate	$5,691.12
Max. Negotiated Rate	$5,691.12
Rate for Payer: AlohaCare Medicaid	$5,691.12
Rate for Payer: Hawaii Medical Service Association ABD	$5,691.12
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,691.12
Rate for Payer: Kaiser Permanente Medicaid	$5,691.12
Rate for Payer: Ohana Health Plan Medicaid	$5,691.12
Rate for Payer: UnitedHealthcare Medicaid	$5,691.12

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$3,615.57

Service Code	APR-DRG 2811
Min. Negotiated Rate	$3,615.57
Max. Negotiated Rate	$3,615.57
Rate for Payer: AlohaCare Medicaid	$3,615.57
Rate for Payer: Hawaii Medical Service Association ABD	$3,615.57
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,615.57
Rate for Payer: Kaiser Permanente Medicaid	$3,615.57
Rate for Payer: Ohana Health Plan Medicaid	$3,615.57
Rate for Payer: UnitedHealthcare Medicaid	$3,615.57

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$8,673.33

Service Code	APR-DRG 2814
Min. Negotiated Rate	$8,673.33
Max. Negotiated Rate	$8,673.33
Rate for Payer: AlohaCare Medicaid	$8,673.33
Rate for Payer: Hawaii Medical Service Association ABD	$8,673.33
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,673.33
Rate for Payer: Kaiser Permanente Medicaid	$8,673.33
Rate for Payer: Ohana Health Plan Medicaid	$8,673.33
Rate for Payer: UnitedHealthcare Medicaid	$8,673.33

MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$4,385.26

Service Code	APR-DRG 2812
Min. Negotiated Rate	$4,385.26
Max. Negotiated Rate	$4,385.26
Rate for Payer: AlohaCare Medicaid	$4,385.26
Rate for Payer: Hawaii Medical Service Association ABD	$4,385.26
Rate for Payer: Hawaii Medical Service Association Non-ABD	$4,385.26
Rate for Payer: Kaiser Permanente Medicaid	$4,385.26
Rate for Payer: Ohana Health Plan Medicaid	$4,385.26
Rate for Payer: UnitedHealthcare Medicaid	$4,385.26

MALIGNANT BREAST DISORDERS

Facility

$8,412.42

Service Code	APR-DRG 3824
Min. Negotiated Rate	$8,412.42
Max. Negotiated Rate	$8,412.42
Rate for Payer: AlohaCare Medicaid	$8,412.42
Rate for Payer: Hawaii Medical Service Association ABD	$8,412.42
Rate for Payer: Hawaii Medical Service Association Non-ABD	$8,412.42
Rate for Payer: Kaiser Permanente Medicaid	$8,412.42
Rate for Payer: Ohana Health Plan Medicaid	$8,412.42
Rate for Payer: UnitedHealthcare Medicaid	$8,412.42

MALIGNANT BREAST DISORDERS

Facility

$3,224.21

Service Code	APR-DRG 3821
Min. Negotiated Rate	$3,224.21
Max. Negotiated Rate	$3,224.21
Rate for Payer: Kaiser Permanente Medicaid	$3,224.21
Rate for Payer: AlohaCare Medicaid	$3,224.21
Rate for Payer: Hawaii Medical Service Association ABD	$3,224.21
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,224.21
Rate for Payer: Ohana Health Plan Medicaid	$3,224.21
Rate for Payer: UnitedHealthcare Medicaid	$3,224.21

MALIGNANT BREAST DISORDERS

Facility

$3,811.91

Service Code	APR-DRG 3822
Min. Negotiated Rate	$3,811.91
Max. Negotiated Rate	$3,811.91
Rate for Payer: AlohaCare Medicaid	$3,811.91
Rate for Payer: Hawaii Medical Service Association ABD	$3,811.91
Rate for Payer: Hawaii Medical Service Association Non-ABD	$3,811.91
Rate for Payer: Kaiser Permanente Medicaid	$3,811.91
Rate for Payer: Ohana Health Plan Medicaid	$3,811.91
Rate for Payer: UnitedHealthcare Medicaid	$3,811.91

MALIGNANT BREAST DISORDERS

Facility

$5,569.79

Service Code	APR-DRG 3823
Min. Negotiated Rate	$5,569.79
Max. Negotiated Rate	$5,569.79
Rate for Payer: AlohaCare Medicaid	$5,569.79
Rate for Payer: Hawaii Medical Service Association ABD	$5,569.79
Rate for Payer: Hawaii Medical Service Association Non-ABD	$5,569.79
Rate for Payer: Kaiser Permanente Medicaid	$5,569.79
Rate for Payer: Ohana Health Plan Medicaid	$5,569.79
Rate for Payer: UnitedHealthcare Medicaid	$5,569.79

MALIGNANT BREAST DISORDERS WITH CC

Facility

$53,215.34

Service Code	MSDRG 598
Min. Negotiated Rate	$12,867.68
Max. Negotiated Rate	$53,215.34
Rate for Payer: AlohaCare Medicare	$12,867.68
Rate for Payer: Devoted Health Medicare	$14,154.45
Rate for Payer: Hawaii Medical Service Association Commercial	$53,215.34
Rate for Payer: Hawaii Medical Service Association Medicare	$12,867.68
Rate for Payer: Humana Medicare	$12,867.68
Rate for Payer: Kaiser Permanente Commercial	$19,514.92
Rate for Payer: Kaiser Permanente Medicare	$12,867.68
Rate for Payer: Ohana Health Plan Medicare	$12,867.68
Rate for Payer: UnitedHealthcare Medicare	$12,867.68

MALIGNANT BREAST DISORDERS WITH MCC

Facility

$53,215.34

Service Code	MSDRG 597
Min. Negotiated Rate	$18,962.01
Max. Negotiated Rate	$53,215.34
Rate for Payer: AlohaCare Medicare	$18,962.01
Rate for Payer: Devoted Health Medicare	$20,858.21
Rate for Payer: Hawaii Medical Service Association Commercial	$53,215.34
Rate for Payer: Hawaii Medical Service Association Medicare	$18,962.01
Rate for Payer: Humana Medicare	$18,962.01
Rate for Payer: Kaiser Permanente Commercial	$28,757.47
Rate for Payer: Kaiser Permanente Medicare	$18,962.01
Rate for Payer: Ohana Health Plan Medicare	$18,962.01
Rate for Payer: UnitedHealthcare Medicare	$18,962.01

MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$12,647.70

Service Code	MSDRG 599
Min. Negotiated Rate	$1,795.68
Max. Negotiated Rate	$12,647.70
Rate for Payer: AlohaCare Medicare	$8,751.34
Rate for Payer: Devoted Health Medicare	$9,626.47
Rate for Payer: Hawaii Medical Service Association Commercial	$1,795.68
Rate for Payer: Hawaii Medical Service Association Medicare	$8,751.34
Rate for Payer: Humana Medicare	$8,751.34
Rate for Payer: Kaiser Permanente Commercial	$12,647.70
Rate for Payer: Kaiser Permanente Medicare	$8,751.34
Rate for Payer: Ohana Health Plan Medicare	$8,751.34
Rate for Payer: UnitedHealthcare Medicare	$8,751.34

MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DISORDERS

Facility

$2,425.82

Service Code	APR-DRG 4211
Min. Negotiated Rate	$2,425.82
Max. Negotiated Rate	$2,425.82
Rate for Payer: AlohaCare Medicaid	$2,425.82
Rate for Payer: Hawaii Medical Service Association ABD	$2,425.82
Rate for Payer: Hawaii Medical Service Association Non-ABD	$2,425.82
Rate for Payer: Kaiser Permanente Medicaid	$2,425.82
Rate for Payer: Ohana Health Plan Medicaid	$2,425.82
Rate for Payer: UnitedHealthcare Medicaid	$2,425.82

Know your out-of-pocket cost for care.

All Charges