Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL IM LNG 125D LF 8525-0340S

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 IM LNG LT 12M 8525-2380S

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 IM LNG LT 12M 8525-2380S

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 INTERMEDIATE RT

Facility

$6,770.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,791.20
Max. Negotiated Rate	$6,566.90
Rate for Payer: Cash Price	$4,062.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,739.00
Rate for Payer: Health Management Network Commercial	$5,754.50
Rate for Payer: MDX Hawaii PPO	$6,566.90
Rate for Payer: University Health Alliance Commercial	$3,791.20

NAIL INTERMEDIATE RT

Facility

$6,770.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,452.70
Max. Negotiated Rate	$6,566.90
Rate for Payer: Cash Price	$4,062.00
Rate for Payer: Hawaii Western Management Group Commercial	$4,739.00
Rate for Payer: Health Management Network Commercial	$5,754.50
Rate for Payer: Kaiser Permanente Commercial	$4,265.10
Rate for Payer: Kaiser Permanente Medicaid	$3,452.70
Rate for Payer: MDX Hawaii PPO	$6,566.90
Rate for Payer: University Health Alliance Commercial	$3,791.20

NAIL INTRAM 9X260 LNG FEMORAL

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,786.13
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: Kaiser Permanente Commercial	$3,441.69
Rate for Payer: Kaiser Permanente Medicaid	$2,786.13
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL INTRAM 9X260 LNG FEMORAL

Facility

$5,463.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,059.28
Max. Negotiated Rate	$5,299.11
Rate for Payer: Cash Price	$3,277.80
Rate for Payer: Hawaii Western Management Group Commercial	$3,824.10
Rate for Payer: Health Management Network Commercial	$4,643.55
Rate for Payer: MDX Hawaii PPO	$5,299.11
Rate for Payer: University Health Alliance Commercial	$3,059.28

NAIL INTRAME125DEG LF 12X440MM

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 INTRAME125DEG LF 12X440MM

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 INTRAMEDULLARY 2341-0936S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$3,228.75
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL INTRAMEDULLARY 2341-0936S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL INTRAMEDULLARY 8525-2340S

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 INTRAMEDULLARY 8525-2340S

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 INTRAMEDULLARY 8530-9300S

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 INTRAMEDULLARY 8530-9300S

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 INTRAMEDULLARY 8530-9320S

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 INTRAMEDULLARY 8530-9320S

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 INTRAME TIB 10 2341-1133S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,870.00
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL INTRAME TIB 10 2341-1133S

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$4,971.25
Rate for Payer: Cash Price	$3,075.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,587.50
Rate for Payer: Health Management Network Commercial	$4,356.25
Rate for Payer: Kaiser Permanente Commercial	$3,228.75
Rate for Payer: Kaiser Permanente Medicaid	$2,613.75
Rate for Payer: MDX Hawaii PPO	$4,971.25
Rate for Payer: University Health Alliance Commercial	$2,870.00

NAIL KIT 11X180X125 3125-1180S

Facility

$3,870.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,167.20
Max. Negotiated Rate	$3,753.90
Rate for Payer: Cash Price	$2,322.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,709.00
Rate for Payer: Health Management Network Commercial	$3,289.50
Rate for Payer: MDX Hawaii PPO	$3,753.90
Rate for Payer: University Health Alliance Commercial	$2,167.20

NAIL KIT 11X180X125 3125-1180S

Facility

$3,870.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,973.70
Max. Negotiated Rate	$3,753.90
Rate for Payer: Cash Price	$2,322.00
Rate for Payer: Hawaii Western Management Group Commercial	$2,709.00
Rate for Payer: Health Management Network Commercial	$3,289.50
Rate for Payer: Kaiser Permanente Commercial	$2,438.10
Rate for Payer: Kaiser Permanente Medicaid	$1,973.70
Rate for Payer: MDX Hawaii PPO	$3,753.90
Rate for Payer: University Health Alliance Commercial	$2,167.20

NAIL KIT GAMMA R1.5 3425-0320S

Facility

$6,402.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,585.12
Max. Negotiated Rate	$6,209.94
Rate for Payer: Cash Price	$3,841.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,481.40
Rate for Payer: Health Management Network Commercial	$5,441.70
Rate for Payer: MDX Hawaii PPO	$6,209.94
Rate for Payer: University Health Alliance Commercial	$3,585.12

NAIL KIT GAMMA R1.5 3425-0320S

Facility

$6,402.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,265.02
Max. Negotiated Rate	$6,209.94
Rate for Payer: Cash Price	$3,841.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,481.40
Rate for Payer: Health Management Network Commercial	$5,441.70
Rate for Payer: Kaiser Permanente Commercial	$4,033.26
Rate for Payer: Kaiser Permanente Medicaid	$3,265.02
Rate for Payer: MDX Hawaii PPO	$6,209.94
Rate for Payer: University Health Alliance Commercial	$3,585.12

NAIL KIT LEFT LONG 3525-0360S

Facility

$6,402.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,265.02
Max. Negotiated Rate	$6,209.94
Rate for Payer: Cash Price	$3,841.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,481.40
Rate for Payer: Health Management Network Commercial	$5,441.70
Rate for Payer: Kaiser Permanente Commercial	$4,033.26
Rate for Payer: Kaiser Permanente Medicaid	$3,265.02
Rate for Payer: MDX Hawaii PPO	$6,209.94
Rate for Payer: University Health Alliance Commercial	$3,585.12

NAIL KIT LEFT LONG 3525-0360S

Facility

$6,402.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,585.12
Max. Negotiated Rate	$6,209.94
Rate for Payer: Cash Price	$3,841.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,481.40
Rate for Payer: Health Management Network Commercial	$5,441.70
Rate for Payer: MDX Hawaii PPO	$6,209.94
Rate for Payer: University Health Alliance Commercial	$3,585.12

Know your out-of-pocket cost for care.

All Charges