In-111 pentetate dtpa / 0.5 mci 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

$411.95

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.

$5,885.00

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.

$141.06 with BLUE CROSS EXCHANGE vs $5,590.75 with HP OF SAN JOAQUIN PPO - ALL OTHER PLANS — 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
BLUE CROSS EXCHANGE BLUE CROSS EXCHANGE $141.06 ↓ -66%
BLUE CROSS NON-MCS - ALL OTHER PLANS BLUE CROSS NON-MCS - ALL OTHER PLANS $156.74 ↓ -62%
TRICARE BLUE SHIELD - ALL PLANS TRICARE BLUE SHIELD - ALL PLANS $745.62 ↑ +81%
HEALTHNET MCARE HEALTHNET MCARE $745.62 ↑ +81%
CCA HEALTH PLAN MCR ADV- ALL PLANS CCA HEALTH PLAN MCR ADV- ALL PLANS $745.62 ↑ +81%
BLUE SHIELD MCARE ADV BLUE SHIELD MCARE ADV $745.62 ↑ +81%
KAISER MCR ADV KAISER MCR ADV $745.62 ↑ +81%
ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS $745.62 ↑ +81%
HUMANA MCR ADV - ALL PLANS HUMANA MCR ADV - ALL PLANS $745.62 ↑ +81%
HP OF SAN JOAQUIN MCR ADV HP OF SAN JOAQUIN MCR ADV $745.62 ↑ +81%
UHC MCR ADV UHC MCR ADV $745.62 ↑ +81%
MEDI-CAL MEDI-CAL $780.87 ↑ +90%
KAISER MCAL KAISER MCAL $780.87 ↑ +90%
CELTIC INS COMPANY - ALL PLANS CELTIC INS COMPANY - ALL PLANS $874.57 ↑ +112%
KNNEX HEALTH - ALL PLANS KNNEX HEALTH - ALL PLANS $894.74 ↑ +117%
HP OF SAN JOAQUIN MCAL HP OF SAN JOAQUIN MCAL $976.09 ↑ +137%
BC MCAL BC MCAL $1,075.26 ↑ +161%
HEALTHNET MCAL HEALTHNET MCAL $1,115.86 ↑ +171%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $1,342.12 ↑ +226%
BRIGHT HEALTH - ALL PLANS BRIGHT HEALTH - ALL PLANS $1,491.24 ↑ +262%
MEDCORE(OMNI IPA) OP ONLY- ALL PLANS MEDCORE(OMNI IPA) OP ONLY- ALL PLANS $1,530.10 ↑ +271%
BLUE SHIELD EPN - ALL OTHER PLANS BLUE SHIELD EPN - ALL OTHER PLANS $1,906.74 ↑ +363%
BLUE SHIELD NON-EPN BLUE SHIELD NON-EPN $1,977.36 ↑ +380%
UHC JLL UHC JLL $2,029.95 ↑ +393%
UHC HMO UHC HMO $2,029.95 ↑ +393%
KAISER COMMERCIAL - ALL OTHER PLANS KAISER COMMERCIAL - ALL OTHER PLANS $2,412.85 ↑ +486%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $2,442.86 ↑ +493%
HEALTHNET- ALL OTHER PLANS HEALTHNET- ALL OTHER PLANS $2,890.12 ↑ +602%
NETWORKS BY DESIGN- ALL PLANS NETWORKS BY DESIGN- ALL PLANS $2,942.50 ↑ +614%
WESTERN GROWERS- ALL PLANS WESTERN GROWERS- ALL PLANS $3,119.05 ↑ +657%
MULTIPLAN- ALL PLANS MULTIPLAN- ALL PLANS $4,708.00 ↑ +1043%
FIRST HEALTH- ALL PLANS FIRST HEALTH- ALL PLANS $4,825.70 ↑ +1071%
THREE RIVERS PROVIDER NETWORK- ALL PLANS THREE RIVERS PROVIDER NETWORK- ALL PLANS $5,296.50 ↑ +1186%
CIGNA- ALL PLANS CIGNA- ALL PLANS $5,296.50 ↑ +1186%
BEECH STREET- ALL PLANS BEECH STREET- ALL PLANS $5,296.50 ↑ +1186%
HP OF SAN JOAQUIN PPO - ALL OTHER PLANS HP OF SAN JOAQUIN PPO - ALL OTHER PLANS $5,590.75 ↑ +1257%

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In-111 pentetate dtpa / 0.5 mci at other California hospitals

Hospital City Cash price Negotiated range
Fresno Medical Center FRESNO $4,666.65 $232.00 – $232.00
St. John's Camarillo Hospital Camarillo $1,712.15 $312.91 – $3,049.02
Antioch Medical Center ANTIOCH $4,666.65 $232.00 – $232.00
Redwood City Medical Center Redwood City $4,666.65 $232.00 – $232.00
Santa Clara Medical Center SANTA CLARA $4,666.65 $232.00 – $232.00
Baldwin Park Medical Center BALDWIN PARK $4,333.32 $207.00 – $207.00
Riverside Medical Center RIVERSIDE $4,333.32 $207.00 – $207.00
Fremont Medical Center FREMONT $4,666.65 $232.00 – $232.00

All California hospitals for this procedure →