Acyclovir 400 mg tablet at LODI MEMORIAL HOSPITAL ASSOCIATION INC

975 S Fairmont Ave, Lodi, CA · Adventisthealth · · NPI 1316938301

Source: hospital's published price file ↗ · Published Aug 2, 2026 · Ingested Sep 16, 2026

$14.56

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$208.06

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$0.28 with MEDCORE(OMNI IPA) OP ONLY- ALL PLANS vs $1.40 with HEALTHNET MCAL — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
MEDCORE(OMNI IPA) OP ONLY- ALL PLANS MEDCORE(OMNI IPA) OP ONLY- ALL PLANS $0.28 ↓ -98%
BLUE SHIELD EPN - ALL OTHER PLANS BLUE SHIELD EPN - ALL OTHER PLANS $0.34 ↓ -98%
WESTERN GROWERS- ALL PLANS WESTERN GROWERS- ALL PLANS $0.36 ↓ -98%
BLUE SHIELD NON-EPN BLUE SHIELD NON-EPN $0.36 ↓ -98%
UHC JLL UHC JLL $0.42 ↓ -97%
AETNA - ALL PLANS AETNA - ALL PLANS $0.43 ↓ -97%
KAISER COMMERCIAL - ALL OTHER PLANS KAISER COMMERCIAL - ALL OTHER PLANS $0.43 ↓ -97%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $0.44 ↓ -97%
UHC HMO UHC HMO $0.44 ↓ -97%
HEALTHNET- ALL OTHER PLANS HEALTHNET- ALL OTHER PLANS $0.52 ↓ -96%
NETWORKS BY DESIGN- ALL PLANS NETWORKS BY DESIGN- ALL PLANS $0.53 ↓ -96%
CIGNA- ALL PLANS CIGNA- ALL PLANS $0.59 ↓ -96%
BLUE CROSS EXCHANGE BLUE CROSS EXCHANGE $0.68 ↓ -95%
BLUE CROSS NON-MCS - ALL OTHER PLANS BLUE CROSS NON-MCS - ALL OTHER PLANS $0.76 ↓ -95%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $0.82 ↓ -94%
MULTIPLAN- ALL PLANS MULTIPLAN- ALL PLANS $0.85 ↓ -94%
FIRST HEALTH- ALL PLANS FIRST HEALTH- ALL PLANS $0.87 ↓ -94%
THREE RIVERS PROVIDER NETWORK- ALL PLANS THREE RIVERS PROVIDER NETWORK- ALL PLANS $0.95 ↓ -93%
BEECH STREET- ALL PLANS BEECH STREET- ALL PLANS $0.95 ↓ -93%
HP OF SAN JOAQUIN PPO - ALL OTHER PLANS HP OF SAN JOAQUIN PPO - ALL OTHER PLANS $1.01 ↓ -93%
KAISER MCAL KAISER MCAL $1.06 ↓ -93%
MEDI-CAL MEDI-CAL $1.06 ↓ -93%
CELTIC INS COMPANY - ALL PLANS CELTIC INS COMPANY - ALL PLANS $1.17 ↓ -92%
BC MCAL BC MCAL $1.17 ↓ -92%
HP MCAL PRO FEE HP MCAL PRO FEE $1.29 ↓ -91%
HP OF SAN JOAQUIN MCAL HP OF SAN JOAQUIN MCAL $1.33 ↓ -91%
HP HEALTHY KIDS PRO FEE HP HEALTHY KIDS PRO FEE $1.36 ↓ -91%
HEALTHNET MCAL HEALTHNET MCAL $1.40 ↓ -90%

Visitor-reported prices

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Acyclovir 400 mg tablet at other California hospitals

Hospital City Cash price Negotiated range
Mercy Medical Center Redding Redding $33.97 $50.92 – $65.66
REEDLEY COMMUNITY HOSPITAL Reedley $60.80 $1.11 – $74.00
ST HELENA HOSPITAL Vallejo $142.93 $141.46 – $141.46
HANFORD COMMUNITY HOSPITAL Selma $87.75 $75.63 – $127.07
SAN JOAQUIN COMMUNITY HOSPITAL Bakersfield $98.87 $85.62 – $232.89
SIERRA VISTA HOSPITAL, INC. San Luis Obispo $126.63 $1.84 – $2.39
ADVENTIST HEALTH DELANO Delano $15.17 $64.49 – $97.87
ADVENTIST HEALTH MENDOCINO COAST Fort Bragg $124.08 $3.00 – $4.35

All California hospitals for this procedure →