Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,251.36
Max. Negotiated Rate	$5,631.82
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,961.06
Max. Negotiated Rate	$5,631.82
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: Kaiser Permanente Commercial	$3,657.78
Rate for Payer: Kaiser Permanente Medicaid	$2,961.06
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: University Health Alliance Commercial	$3,251.36

NAIL TI CANN HUMERAL 7X200MM

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 TI CANN HUMERAL 7X200MM

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 TI CANN HUMERAL 7X210MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X210MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X220MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X220MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X230MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X230MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X240MM

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 TI CANN HUMERAL 7X240MM

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 TI CANN HUMERAL 7X250MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X250MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X260MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X260MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X270MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X270MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X280MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X280MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X290MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X290MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X300MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,050.82
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: Kaiser Permanente Commercial	$3,768.66
Rate for Payer: Kaiser Permanente Medicaid	$3,050.82
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 7X300MM

Facility

$5,982.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.92
Max. Negotiated Rate	$5,802.54
Rate for Payer: Cash Price	$3,589.20
Rate for Payer: Hawaii Western Management Group Commercial	$4,187.40
Rate for Payer: Health Management Network Commercial	$5,084.70
Rate for Payer: MDX Hawaii PPO	$5,802.54
Rate for Payer: University Health Alliance Commercial	$3,349.92

NAIL TI CANN HUMERAL 9X150MM

Facility

$5,806.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$3,251.36
Max. Negotiated Rate	$5,631.82
Rate for Payer: Cash Price	$3,483.60
Rate for Payer: Hawaii Western Management Group Commercial	$4,064.20
Rate for Payer: Health Management Network Commercial	$4,935.10
Rate for Payer: MDX Hawaii PPO	$5,631.82
Rate for Payer: University Health Alliance Commercial	$3,251.36

Know your out-of-pocket cost for care.

All Charges