Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL KIT LONG 3525-1380S

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 LONG 3525-1380S

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 R 360X11MM 3425-1360S

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 R 360X11MM 3425-1360S

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 L340MM 04.033.164S

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 L340MM 04.033.164S

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 LEFT 11X200 1818-1120S

Facility

$6,567.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.17
Max. Negotiated Rate	$6,369.99
Rate for Payer: Cash Price	$3,940.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,596.90
Rate for Payer: Health Management Network Commercial	$5,581.95
Rate for Payer: Kaiser Permanente Commercial	$4,137.21
Rate for Payer: Kaiser Permanente Medicaid	$3,349.17
Rate for Payer: MDX Hawaii PPO	$6,369.99
Rate for Payer: University Health Alliance Commercial	$3,677.52

NAIL LEFT 11X200 1818-1120S

Facility

$6,567.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,677.52
Max. Negotiated Rate	$6,369.99
Rate for Payer: Cash Price	$3,940.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,596.90
Rate for Payer: Health Management Network Commercial	$5,581.95
Rate for Payer: MDX Hawaii PPO	$6,369.99
Rate for Payer: University Health Alliance Commercial	$3,677.52

NAIL LNG 125 DEG LF 8525-2320S

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 LNG 125 DEG LF 8525-2320S

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 LNG 125 DEG LF 8525-2420S

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 LNG 125 DEG LF 8525-2420S

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 LNG RT 10X340 8425-0340S

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 LNG RT 10X340 8425-0340S

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 LNG RT 8425-1400S

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 LNG RT 8425-1400S

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 LONG 12X380MM 8425-2380S

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 LONG 12X380MM 8425-2380S

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 LONG 8525-0320S

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 LONG 8525-0320S

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 LONG GAMMA4 RT 8425-1340S

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 LONG GAMMA4 RT 8425-1340S

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 LONG LEFT 8525-2360S

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 LONG LEFT 8525-2360S

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 LONG LF

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

Know your out-of-pocket cost for care.

All Charges