CPT 57130
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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$4,206.58Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.43This 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
Price Negotiated by Insurer
$848.00Deductible 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.
ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION [205406]
$0.05DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$0.12DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$0.90FENTANYL 2500 MCG/250 ML (10 MCG/ML) IN D5W INFUSION (SIMPLE) [4080505]
$0.96KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.35ONDANSETRON 16 MG IN 50 ML NS IVPB-CNR FROM MDV (SIMPLE) [4080023]
$0.09This 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
Price Negotiated by Insurer
$8,270.00Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.49This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$1,427.62Deductible 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.
ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION [205406]
$0.05DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$0.12DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$0.90FENTANYL 2500 MCG/250 ML (10 MCG/ML) IN D5W INFUSION (SIMPLE) [4080505]
$0.96KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.35ONDANSETRON 16 MG IN 50 ML NS IVPB-CNR FROM MDV (SIMPLE) [4080023]
$0.09This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$2,837.00Deductible 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.
ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION [205406]
$13.26DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$18.36DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.57FENTANYL 2500 MCG/250 ML (10 MCG/ML) IN D5W INFUSION (SIMPLE) [4080505]
$60.18KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$10.71ONDANSETRON 16 MG IN 50 ML NS IVPB-CNR FROM MDV (SIMPLE) [4080023]
$8.16This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$4,206.58Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.43This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$456.03Deductible 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.
ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION [205406]
$18.00DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$6.00DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$3.00FENTANYL 2500 MCG/250 ML (10 MCG/ML) IN D5W INFUSION (SIMPLE) [4080505]
$60.60KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$9.00ONDANSETRON 16 MG IN 50 ML NS IVPB-CNR FROM MDV (SIMPLE) [4080023]
$2.40This 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
Price Negotiated by Insurer
$3,824.16Deductible 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.
KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$0.39This 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
Price Negotiated by Insurer
$5,160.40Deductible 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.
ACETAMINOPHEN 500 MG/50 ML (10 MG/ML) INTRAVENOUS SOLUTION [205406]
$18.95DEXAMETHASONE 40 MG IN 50 ML NS IVPB (SIMPLE) [4080503]
$26.24DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION [2508]
$5.10FENTANYL 2500 MCG/250 ML (10 MCG/ML) IN D5W INFUSION (SIMPLE) [4080505]
$86.01KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION [22473]
$15.31ONDANSETRON 16 MG IN 50 ML NS IVPB-CNR FROM MDV (SIMPLE) [4080023]
$11.66This 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.