Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL 13X360MM TI 04.013.752S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$2,501.10
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X360MM TI 04.013.752S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X380MM TI 04.013.756S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.70
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: Kaiser Permanente Commercial	$2,501.10
Rate for Payer: Kaiser Permanente Medicaid	$2,024.70
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 13X380MM TI 04.013.756S

Facility

$3,970.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,223.20
Max. Negotiated Rate	$3,850.90
Rate for Payer: Cash Price	$2,382.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,779.00
Rate for Payer: Health Management Network Commercial	$3,374.50
Rate for Payer: MDX Hawaii PPO	$3,850.90
Rate for Payer: University Health Alliance Commercial	$2,223.20

NAIL 1.8MM THRD IM TI 38MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 1.8MM THRD IM TI 38MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,053.80
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.0X440MM ELASTC 475.920S

Facility

$1,332.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$745.92
Max. Negotiated Rate	$1,292.04
Rate for Payer: Cash Price	$799.20
Rate for Payer: Hawaii Western Management Group Commercial	$932.40
Rate for Payer: Health Management Network Commercial	$1,132.20
Rate for Payer: MDX Hawaii PPO	$1,292.04
Rate for Payer: University Health Alliance Commercial	$745.92

NAIL 2.0X440MM ELASTC 475.920S

Facility

$1,332.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$679.32
Max. Negotiated Rate	$1,292.04
Rate for Payer: Cash Price	$799.20
Rate for Payer: Hawaii Western Management Group Commercial	$932.40
Rate for Payer: Health Management Network Commercial	$1,132.20
Rate for Payer: Kaiser Permanente Commercial	$839.16
Rate for Payer: Kaiser Permanente Medicaid	$679.32
Rate for Payer: MDX Hawaii PPO	$1,292.04
Rate for Payer: University Health Alliance Commercial	$745.92

NAIL 2.1 T IM THRD GOLD 45MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,053.80
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.1 T IM THRD GOLD 45MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 2.5X440MM ELASTC 475.925S

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$722.16
Max. Negotiated Rate	$1,373.52
Rate for Payer: Cash Price	$849.60
Rate for Payer: Hawaii Western Management Group Commercial	$991.20
Rate for Payer: Health Management Network Commercial	$1,203.60
Rate for Payer: Kaiser Permanente Commercial	$892.08
Rate for Payer: Kaiser Permanente Medicaid	$722.16
Rate for Payer: MDX Hawaii PPO	$1,373.52
Rate for Payer: University Health Alliance Commercial	$792.96

NAIL 2.5X440MM ELASTC 475.925S

Facility

$1,416.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$792.96
Max. Negotiated Rate	$1,373.52
Rate for Payer: Cash Price	$849.60
Rate for Payer: Hawaii Western Management Group Commercial	$991.20
Rate for Payer: Health Management Network Commercial	$1,203.60
Rate for Payer: MDX Hawaii PPO	$1,373.52
Rate for Payer: University Health Alliance Commercial	$792.96

NAIL 3.0 T IM THRD LT BLU 40MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,825.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 3.0 T IM THRD LT BLU 40MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.60
Max. Negotiated Rate	$3,162.20
Rate for Payer: Cash Price	$1,956.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,282.00
Rate for Payer: Health Management Network Commercial	$2,771.00
Rate for Payer: Kaiser Permanente Commercial	$2,053.80
Rate for Payer: Kaiser Permanente Medicaid	$1,662.60
Rate for Payer: MDX Hawaii PPO	$3,162.20
Rate for Payer: University Health Alliance Commercial	$1,825.60

NAIL 3.5X440MM ELASTC 475.935S

Facility

$1,541.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$785.91
Max. Negotiated Rate	$1,494.77
Rate for Payer: Cash Price	$924.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,078.70
Rate for Payer: Health Management Network Commercial	$1,309.85
Rate for Payer: Kaiser Permanente Commercial	$970.83
Rate for Payer: Kaiser Permanente Medicaid	$785.91
Rate for Payer: MDX Hawaii PPO	$1,494.77
Rate for Payer: University Health Alliance Commercial	$862.96

NAIL 3.5X440MM ELASTC 475.935S

Facility

$1,541.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$862.96
Max. Negotiated Rate	$1,494.77
Rate for Payer: Cash Price	$924.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,078.70
Rate for Payer: Health Management Network Commercial	$1,309.85
Rate for Payer: MDX Hawaii PPO	$1,494.77
Rate for Payer: University Health Alliance Commercial	$862.96

NAIL 60MM SPIRAL 04.013.044S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 60MM SPIRAL 04.013.044S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,076.61
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,329.93
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 70MM SPIRAL 04.013.046S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,076.61
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,329.93
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 70MM SPIRAL 04.013.046S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 75MM SPIRAL 04.013.047S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,076.61
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,329.93
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 75MM SPIRAL 04.013.047S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 80MM SPIRAL 04.013.048S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 80MM SPIRAL 04.013.048S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,076.61
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: Kaiser Permanente Commercial	$1,329.93
Rate for Payer: Kaiser Permanente Medicaid	$1,076.61
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

NAIL 90MM SPIRAL 04.013.050S

Facility

$2,111.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,182.16
Max. Negotiated Rate	$2,047.67
Rate for Payer: Cash Price	$1,266.60
Rate for Payer: Hawaii Western Management Group Commercial	$1,477.70
Rate for Payer: Health Management Network Commercial	$1,794.35
Rate for Payer: MDX Hawaii PPO	$2,047.67
Rate for Payer: University Health Alliance Commercial	$1,182.16

Know your out-of-pocket cost for care.

All Charges