Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

NAIL TI CANN HUMERAL 9X150MM

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 9X200MM

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 9X200MM

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 9X210MM

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 9X210MM

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 9X220MM

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 9X220MM

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 9X230MM

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 9X230MM

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 9X240MM

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 9X240MM

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 9X270MM

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 9X270MM

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 9X280MM

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 9X280MM

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 9X290MM

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 9X290MM

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 9X300MM

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 9X300MM

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 END CAP 04.004.000S

Facility

$925.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$518.00
Max. Negotiated Rate	$897.25
Rate for Payer: Cash Price	$555.00
Rate for Payer: Hawaii Western Management Group Commercial	$647.50
Rate for Payer: Health Management Network Commercial	$786.25
Rate for Payer: MDX Hawaii PPO	$897.25
Rate for Payer: University Health Alliance Commercial	$518.00

NAIL TI END CAP 04.004.000S

Facility

$925.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$471.75
Max. Negotiated Rate	$897.25
Rate for Payer: Cash Price	$555.00
Rate for Payer: Hawaii Western Management Group Commercial	$647.50
Rate for Payer: Health Management Network Commercial	$786.25
Rate for Payer: Kaiser Permanente Commercial	$582.75
Rate for Payer: Kaiser Permanente Medicaid	$471.75
Rate for Payer: MDX Hawaii PPO	$897.25
Rate for Payer: University Health Alliance Commercial	$518.00

NAIL TI END CAP 04.004.002S

Facility

$1,130.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$632.80
Max. Negotiated Rate	$1,096.10
Rate for Payer: Cash Price	$678.00
Rate for Payer: Hawaii Western Management Group Commercial	$791.00
Rate for Payer: Health Management Network Commercial	$960.50
Rate for Payer: MDX Hawaii PPO	$1,096.10
Rate for Payer: University Health Alliance Commercial	$632.80

NAIL TI END CAP 04.004.002S

Facility

$1,130.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$576.30
Max. Negotiated Rate	$1,096.10
Rate for Payer: Cash Price	$678.00
Rate for Payer: Hawaii Western Management Group Commercial	$791.00
Rate for Payer: Health Management Network Commercial	$960.50
Rate for Payer: Kaiser Permanente Commercial	$711.90
Rate for Payer: Kaiser Permanente Medicaid	$576.30
Rate for Payer: MDX Hawaii PPO	$1,096.10
Rate for Payer: University Health Alliance Commercial	$632.80

NAIL TRCH 3 GMA 3125-0170S

Facility

$4,730.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,648.80
Max. Negotiated Rate	$4,588.10
Rate for Payer: Cash Price	$2,838.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,311.00
Rate for Payer: Health Management Network Commercial	$4,020.50
Rate for Payer: MDX Hawaii PPO	$4,588.10
Rate for Payer: University Health Alliance Commercial	$2,648.80

NAIL TRCH 3 GMA 3125-0170S

Facility

$4,730.00

Service Code	HCPCS C1713
Hospital Revenue Code	278
Min. Negotiated Rate	$2,412.30
Max. Negotiated Rate	$4,588.10
Rate for Payer: Cash Price	$2,838.00
Rate for Payer: Hawaii Western Management Group Commercial	$3,311.00
Rate for Payer: Health Management Network Commercial	$4,020.50
Rate for Payer: Kaiser Permanente Commercial	$2,979.90
Rate for Payer: Kaiser Permanente Medicaid	$2,412.30
Rate for Payer: MDX Hawaii PPO	$4,588.10
Rate for Payer: University Health Alliance Commercial	$2,648.80

Know your out-of-pocket cost for care.

All Charges