But there is only one difficulty setting above Hardcore. If you select "Very Hard" the only thing that happens above hardcore is that the monster's base damage is doubled (technically it is just the number of sides of the die that are doubled). So if you place a monster with 10d20 monster damage on its claw (105 average), the "Very Hard" setting will add 100 damage to that (from 10d20 to 10d40). If you instead give monsters typical PC weapons like the 2d6 greatsword, then you will only see a 6 additional damage from "Very Hard", not that great. Even if you give that greatsword a bunch of damage bonuses (e.g. 2d6 acid or enhancement +20) and gave the monster 100 strength, the "Very Hard" setting will still only add 6 damage, because it only affects the base damage of the weapon.
So if the builder chooses to, he could make the difference between Very Hard and Hardcore to be quite large, or he could make it quite minute, depending on the type of monsters he designs.