Hilo Benioff Medical Center

All Charges

Charge

Type

Setting

Price

PERSONA FEM PS POR NRW SZ1 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ1 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ1 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ1 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ2 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ2 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ2 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ2 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ3 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ4 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ5 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ6 R

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$10,186.74
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Kaiser Permanente Commercial	$12,583.62
Rate for Payer: Kaiser Permanente Medicaid	$10,186.74
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: University Health Alliance Commercial	$11,185.44

PERSONA FEM PS POR NRW SZ7 L

Facility

$19,974.00

Service Code	HCPCS C1776
Hospital Revenue Code	278
Min. Negotiated Rate	$11,185.44
Max. Negotiated Rate	$19,374.78
Rate for Payer: Cash Price	$11,984.40
Rate for Payer: Cash Price	$4,440.00
Rate for Payer: Hawaii Western Management Group Commercial	$5,180.00
Rate for Payer: Hawaii Western Management Group Commercial	$13,981.80
Rate for Payer: Health Management Network Commercial	$16,977.90
Rate for Payer: Health Management Network Commercial	$6,290.00
Rate for Payer: MDX Hawaii PPO	$19,374.78
Rate for Payer: MDX Hawaii PPO	$7,178.00
Rate for Payer: University Health Alliance Commercial	$4,144.00
Rate for Payer: University Health Alliance Commercial	$11,185.44

Know your out-of-pocket cost for care.

All Charges