Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL 11X340 3525-1340S

Facility

$6,789.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,462.39
Max. Negotiated Rate	$6,585.33
Rate for Payer: Cash Price	$4,073.40
Rate for Payer: Hawaii Western Management Group Commercial	$4,752.30
Rate for Payer: Health Management Network Commercial	$5,770.65
Rate for Payer: Kaiser Permanente Commercial	$4,277.07
Rate for Payer: Kaiser Permanente Medicaid	$3,462.39
Rate for Payer: MDX Hawaii PPO	$6,585.33
Rate for Payer: University Health Alliance Commercial	$3,801.84

NAIL 11X340 3525-1340S

Facility

$6,789.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,801.84
Max. Negotiated Rate	$6,585.33
Rate for Payer: Cash Price	$4,073.40
Rate for Payer: Hawaii Western Management Group Commercial	$4,752.30
Rate for Payer: Health Management Network Commercial	$5,770.65
Rate for Payer: MDX Hawaii PPO	$6,585.33
Rate for Payer: University Health Alliance Commercial	$3,801.84

NAIL 11X340MM LEFT 04.037.155S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X340MM LEFT 04.037.155S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X340MM RT 04.037.154S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X340MM RT 04.037.154S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X360MM LEFT 04.037.157S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X360MM LEFT 04.037.157S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X360MM RT 04.037.156S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X360MM RT 04.037.156S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X380MM LEFT 04.037.159S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X380MM LEFT 04.037.159S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X380MM RT 04.037.158S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X380MM RT 04.037.158S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X400MM RT 04.037.160S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X400MM RT 04.037.160S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X420MM LEFT 04.037.163S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,889.15
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: Kaiser Permanente Commercial	$3,568.95
Rate for Payer: Kaiser Permanente Medicaid	$2,889.15
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 11X420MM LEFT 04.037.163S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

NAIL 125 DEG 12MM DIA 40CM

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,482.17
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: Kaiser Permanente Commercial	$3,066.21
Rate for Payer: Kaiser Permanente Medicaid	$2,482.17
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL 125 DEG 12MM DIA 40CM

Facility

$4,867.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,725.52
Max. Negotiated Rate	$4,720.99
Rate for Payer: Cash Price	$2,920.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,406.90
Rate for Payer: Health Management Network Commercial	$4,136.95
Rate for Payer: MDX Hawaii PPO	$4,720.99
Rate for Payer: University Health Alliance Commercial	$2,725.52

NAIL 12MM/340MM LF 04.033.265S

Facility

$5,002.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,801.12
Max. Negotiated Rate	$4,851.94
Rate for Payer: Cash Price	$3,001.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,501.40
Rate for Payer: Health Management Network Commercial	$4,251.70
Rate for Payer: MDX Hawaii PPO	$4,851.94
Rate for Payer: University Health Alliance Commercial	$2,801.12

NAIL 12MM/340MM LF 04.033.265S

Facility

$5,002.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,551.02
Max. Negotiated Rate	$4,851.94
Rate for Payer: Cash Price	$3,001.20
Rate for Payer: Hawaii Western Management Group Commercial	$3,501.40
Rate for Payer: Health Management Network Commercial	$4,251.70
Rate for Payer: Kaiser Permanente Commercial	$3,151.26
Rate for Payer: Kaiser Permanente Medicaid	$2,551.02
Rate for Payer: MDX Hawaii PPO	$4,851.94
Rate for Payer: University Health Alliance Commercial	$2,801.12

NAIL 12X170MM/130° 04.037.242S

Facility

$4,045.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,265.20
Max. Negotiated Rate	$3,923.65
Rate for Payer: Cash Price	$2,427.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,831.50
Rate for Payer: Health Management Network Commercial	$3,438.25
Rate for Payer: MDX Hawaii PPO	$3,923.65
Rate for Payer: University Health Alliance Commercial	$2,265.20

NAIL 12X170MM/130° 04.037.242S

Facility

$4,045.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.95
Max. Negotiated Rate	$3,923.65
Rate for Payer: Cash Price	$2,427.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,831.50
Rate for Payer: Health Management Network Commercial	$3,438.25
Rate for Payer: Kaiser Permanente Commercial	$2,548.35
Rate for Payer: Kaiser Permanente Medicaid	$2,062.95
Rate for Payer: MDX Hawaii PPO	$3,923.65
Rate for Payer: University Health Alliance Commercial	$2,265.20

NAIL 12X320MM RT 04.037.252S

Facility

$5,665.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,172.40
Max. Negotiated Rate	$5,495.05
Rate for Payer: Cash Price	$3,399.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,965.50
Rate for Payer: Health Management Network Commercial	$4,815.25
Rate for Payer: MDX Hawaii PPO	$5,495.05
Rate for Payer: University Health Alliance Commercial	$3,172.40

Know your out-of-pocket cost for care.

All Charges