Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL GAMMA4 LONG LF 8525-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,294.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$4,069.80
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG LF 8525-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG LF 8525-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.92
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$4,467.96
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 LONG LF 8525-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 LONG RT 8425-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,294.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$4,069.80
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-1380S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-2360S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,294.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$4,069.80
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8425-2360S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA4 LONG RT 8430-0400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 LONG RT 8430-0400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.92
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$4,467.96
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 LONG RT 8430-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.92
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$4,467.96
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 LONG RT 8430-1400S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.52
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

NAIL GAMMA4 TROCHAN 8125-9170S

Facility

$4,781.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,438.31
Max. Negotiated Rate	$4,637.57
Rate for Payer: Cash Price	$2,868.60
Rate for Payer: Hawaii Western Management Group Commercial	$3,346.70
Rate for Payer: Health Management Network Commercial	$4,063.85
Rate for Payer: Kaiser Permanente Commercial	$3,012.03
Rate for Payer: Kaiser Permanente Medicaid	$2,438.31
Rate for Payer: MDX Hawaii PPO	$4,637.57
Rate for Payer: University Health Alliance Commercial	$2,677.36

NAIL GAMMA4 TROCHAN 8125-9170S

Facility

$4,781.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,677.36
Max. Negotiated Rate	$4,637.57
Rate for Payer: Cash Price	$2,868.60
Rate for Payer: Hawaii Western Management Group Commercial	$3,346.70
Rate for Payer: Health Management Network Commercial	$4,063.85
Rate for Payer: MDX Hawaii PPO	$4,637.57
Rate for Payer: University Health Alliance Commercial	$2,677.36

NAIL GAMMA LNG RT 8425-2280S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,617.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL GAMMA LNG RT 8425-2280S

Facility

$6,460.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,294.60
Max. Negotiated Rate	$6,266.20
Rate for Payer: Cash Price	$3,876.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,522.00
Rate for Payer: Health Management Network Commercial	$5,491.00
Rate for Payer: Kaiser Permanente Commercial	$4,069.80
Rate for Payer: Kaiser Permanente Medicaid	$3,294.60
Rate for Payer: MDX Hawaii PPO	$6,266.20
Rate for Payer: University Health Alliance Commercial	$3,617.60

NAIL HUMERAL 9X270 1830-0927S

Facility

$3,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,674.84
Max. Negotiated Rate	$3,185.48
Rate for Payer: Cash Price	$1,970.40
Rate for Payer: Hawaii Western Management Group Commercial	$2,298.80
Rate for Payer: Health Management Network Commercial	$2,791.40
Rate for Payer: Kaiser Permanente Commercial	$2,068.92
Rate for Payer: Kaiser Permanente Medicaid	$1,674.84
Rate for Payer: MDX Hawaii PPO	$3,185.48
Rate for Payer: University Health Alliance Commercial	$1,839.04

NAIL HUMERAL 9X270 1830-0927S

Facility

$3,284.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,839.04
Max. Negotiated Rate	$3,185.48
Rate for Payer: Cash Price	$1,970.40
Rate for Payer: Hawaii Western Management Group Commercial	$2,298.80
Rate for Payer: Health Management Network Commercial	$2,791.40
Rate for Payer: MDX Hawaii PPO	$3,185.48
Rate for Payer: University Health Alliance Commercial	$1,839.04

NAIL HUMERAL CANN TI 9X250MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,311.68
Max. Negotiated Rate	$4,004.16
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL HUMERAL CANN TI 9X250MM

Facility

$4,128.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,105.28
Max. Negotiated Rate	$4,004.16
Rate for Payer: Cash Price	$2,476.80
Rate for Payer: Hawaii Western Management Group Commercial	$2,889.60
Rate for Payer: Health Management Network Commercial	$3,508.80
Rate for Payer: Kaiser Permanente Commercial	$2,600.64
Rate for Payer: Kaiser Permanente Medicaid	$2,105.28
Rate for Payer: MDX Hawaii PPO	$4,004.16
Rate for Payer: University Health Alliance Commercial	$2,311.68

NAIL HUMERAL LF 1832-1035S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,344.88
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL HUMERAL LF 1832-1035S

Facility

$5,973.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,046.23
Max. Negotiated Rate	$5,793.81
Rate for Payer: Cash Price	$3,583.80
Rate for Payer: Hawaii Western Management Group Commercial	$4,181.10
Rate for Payer: Health Management Network Commercial	$5,077.05
Rate for Payer: Kaiser Permanente Commercial	$3,762.99
Rate for Payer: Kaiser Permanente Medicaid	$3,046.23
Rate for Payer: MDX Hawaii PPO	$5,793.81
Rate for Payer: University Health Alliance Commercial	$3,344.88

NAIL HUMERAL LONG RIGHT 8X220

Facility

$4,070.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,279.20
Max. Negotiated Rate	$3,947.90
Rate for Payer: Cash Price	$2,442.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,849.00
Rate for Payer: Health Management Network Commercial	$3,459.50
Rate for Payer: MDX Hawaii PPO	$3,947.90
Rate for Payer: University Health Alliance Commercial	$2,279.20

NAIL HUMERAL LONG RIGHT 8X220

Facility

$4,070.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,075.70
Max. Negotiated Rate	$3,947.90
Rate for Payer: Cash Price	$2,442.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,849.00
Rate for Payer: Health Management Network Commercial	$3,459.50
Rate for Payer: Kaiser Permanente Commercial	$2,564.10
Rate for Payer: Kaiser Permanente Medicaid	$2,075.70
Rate for Payer: MDX Hawaii PPO	$3,947.90
Rate for Payer: University Health Alliance Commercial	$2,279.20

NAIL IM LNG 125D LF 8525-0340S

Facility

$7,092.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.92
Max. Negotiated Rate	$6,879.24
Rate for Payer: Cash Price	$4,255.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,964.40
Rate for Payer: Health Management Network Commercial	$6,028.20
Rate for Payer: Kaiser Permanente Commercial	$4,467.96
Rate for Payer: Kaiser Permanente Medicaid	$3,616.92
Rate for Payer: MDX Hawaii PPO	$6,879.24
Rate for Payer: University Health Alliance Commercial	$3,971.52

Know your out-of-pocket cost for care.

All Charges