CPT 96415
The standard charge for Chemotherapy infusion-each additional hour is $283.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
1190 Waianuenue Avenue, Hilo, HI, 96720CONTACT
(808) 932-3000 Visit WebsiteIn compliance with the Centers for Medicare and Medicaid Services (CMS) Final 2020 Price Transparency Rules, effective January 1, 2021, all hospitals in the United States annually must provide a machine-readable file containing negotiated charges (rates) for ALL items and services. Additionally, the rule requires that for 300 shoppable items and services only, hospitals must provide a consumer-friendly display of gross charge and negotiated charges (rates) or estimation tool. Accordingly, below you will find links to the consumer estimation tool and the machine-readable file.
The fees and/or costs provided via this tool are only estimates, and your final bill may be higher or lower than the estimate for various reasons including but not limited to differences in the number of conditions among patients having the same or similar primary procedures, differences in physician ordering practices, unforeseen complications, etc. Moreover, this is not a guarantee of your benefit plan coverage or payment, and the actual payer and patient portion reflected in your final bill may also be higher or lower.
In some instances, where no recent historical claims and/or payment information is available for the payer plan and the item or service you have selected, the estimate may be for the base rate only or not available. Consequently, the estimate may exclude estimates for additional charges and payer payments for services billed in conjunction with the item or service you selected.
Also, this estimate DOES NOT include other services billed for separately by other providers including but not limited to physician or practitioner fees such as pathologist, radiologist, anesthesiologist, physician surgeon or assistant surgeon, etc.
Your individual responsibility is governed by the services ordered and performed by your physician as well as your individual, employer-provided or governmental insurance plan. Discounts are available for patients without insurance depending on household income levels. If you do not have health insurance, please contact our Patient Financial Service representative at (808) 932-1446 or (808) 932-1453 to determine if you qualify for the various financial assistance programs available.
Choose a plan to view the insurance rate estimate.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$113.20Price Negotiated by Insurer
$169.80Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$6.00DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.60FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$9.00FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$75.60HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$169.80HC CHEMOTHER, IV INFUSION, 1 HR
$792.00HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$143.40HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$220.80LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$95.40OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$63.00PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$252.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$189.43Price Negotiated by Insurer
$93.57Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$93.57HC CHEMOTHER, IV INFUSION, 1 HR
$429.22HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$60.85HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$93.57This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$176.67Price Negotiated by Insurer
$106.33Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$106.33HC CHEMOTHER, IV INFUSION, 1 HR
$487.75HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$69.15HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$106.33This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$14.15Price Negotiated by Insurer
$268.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$9.50DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$4.75FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$94.05FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$394.25HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$268.85HC CHEMOTHER, IV INFUSION, 1 HR
$1,254.00HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$227.05HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$349.60LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$28.50OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$171.00PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$36.10This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$42.45Price Negotiated by Insurer
$240.55Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$8.50DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$4.25FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$21.25FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$352.75HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$240.55HC CHEMOTHER, IV INFUSION, 1 HR
$1,122.00HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$203.15HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$312.80LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$135.15OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$385.05PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$357.00This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$104.71Price Negotiated by Insurer
$178.29Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$22.68DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.15FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$62.37FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$79.38HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$178.29HC CHEMOTHER, IV INFUSION, 1 HR
$831.60HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$150.57HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$231.84LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$18.90OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$285.39PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$23.94This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$138.67Price Negotiated by Insurer
$144.33Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$18.36DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.57FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$7.65FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$574.77HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$144.33HC CHEMOTHER, IV INFUSION, 1 HR
$673.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$121.89HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$187.68LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$81.09OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$91.80PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$214.20This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$8.49Price Negotiated by Insurer
$274.51Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$9.70DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$4.85FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$24.25FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$402.55HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$274.51HC CHEMOTHER, IV INFUSION, 1 HR
$1,280.40HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$231.83HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$356.96LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$154.23OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$439.41PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$407.40This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$189.43Price Negotiated by Insurer
$93.57Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$93.57HC CHEMOTHER, IV INFUSION, 1 HR
$429.22HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$60.85HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$93.57This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$244.69Price Negotiated by Insurer
$38.31Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$6.00DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.00FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$59.40FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$676.20HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$55.33HC CHEMOTHER, IV INFUSION, 1 HR
$113.96HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$15.80HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$23.03LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$18.00OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$271.80PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$22.80This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$197.94Price Negotiated by Insurer
$85.06Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$85.06HC CHEMOTHER, IV INFUSION, 1 HR
$390.20HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$55.32HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$85.06This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.
Total estimated charges
$283.00Insurance Discount
-$76.72Price Negotiated by Insurer
$206.28Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$26.24DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$5.10FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION [82200]
$10.93FOSAPREPITANT 150 MG IN 250 ML NS IVPB-CNR (SIMPLE) [4080025]
$821.47HC CHEMOTHER, IV INFUSE, EACH SEQU INFUS
$206.28HC CHEMOTHER, IV INFUSION, 1 HR
$962.15HC INJECTION,THERAP/PROPH/DIAGNOST, IV PUSH, EA ADD, NEW DRUG
$174.21HC IV INFUSION, THERAP/PROPH/DIAGNOST,ADD INFUSION,1ST HOUR
$268.24LEUCOVORIN CALCIUM 500 MG SOLUTION FOR INJECTION [23617]
$115.90OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION [99610]
$131.20PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
$306.14This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Hilo Benioff Medical Center so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Hilo Benioff Medical Center directly at (808) 932-3000.