Mouth vestibule bx/w complex rpr 40814 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

$70.91

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.

$1,013.00

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.

$237.16 with MEDI-CAL vs $8,745.94 with BRIGHT HEALTH - ALL 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
MEDI-CAL MEDI-CAL $237.16 ↑ +234%
BC MCAL BC MCAL $237.16 ↑ +234%
KAISER MCAL KAISER MCAL $237.16 ↑ +234%
CELTIC INS COMPANY - ALL PLANS CELTIC INS COMPANY - ALL PLANS $237.16 ↑ +234%
HP MCAL PRO FEE HP MCAL PRO FEE $260.88 ↑ +268%
MEDCORE(OMNI IPA) OP ONLY- ALL PLANS MEDCORE(OMNI IPA) OP ONLY- ALL PLANS $263.38 ↑ +271%
UHC MCR ADV UHC MCR ADV $272.65 ↑ +285%
HP OF SAN JOAQUIN MCR ADV HP OF SAN JOAQUIN MCR ADV $272.65 ↑ +285%
HEALTHNET MCARE HEALTHNET MCARE $272.65 ↑ +285%
BLUE SHIELD MCARE ADV BLUE SHIELD MCARE ADV $272.65 ↑ +285%
ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS $272.65 ↑ +285%
TRICARE BLUE SHIELD - ALL PLANS TRICARE BLUE SHIELD - ALL PLANS $272.65 ↑ +285%
KNNEX HEALTH - ALL PLANS KNNEX HEALTH - ALL PLANS $272.65 ↑ +285%
HUMANA MCR ADV - ALL PLANS HUMANA MCR ADV - ALL PLANS $272.65 ↑ +285%
HEALTHNET MCAL HEALTHNET MCAL $284.59 ↑ +301%
HP OF SAN JOAQUIN MCAL HP OF SAN JOAQUIN MCAL $284.59 ↑ +301%
HP HEALTHY KIDS PRO FEE HP HEALTHY KIDS PRO FEE $286.28 ↑ +304%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $299.92 ↑ +323%
FIRST HEALTH- ALL PLANS FIRST HEALTH- ALL PLANS $327.18 ↑ +361%
BLUE SHIELD EPN - ALL OTHER PLANS BLUE SHIELD EPN - ALL OTHER PLANS $328.21 ↑ +363%
BLUE SHIELD NON-EPN BLUE SHIELD NON-EPN $340.37 ↑ +380%
MULTIPLAN- ALL PLANS MULTIPLAN- ALL PLANS $354.45 ↑ +400%
HP OF SAN JOAQUIN PPO - ALL OTHER PLANS HP OF SAN JOAQUIN PPO - ALL OTHER PLANS $354.45 ↑ +400%
BEECH STREET- ALL PLANS BEECH STREET- ALL PLANS $354.45 ↑ +400%
CIGNA- ALL PLANS CIGNA- ALL PLANS $362.00 ↑ +411%
KAISER MCR ADV KAISER MCR ADV $368.08 ↑ +419%
KAISER COMMERCIAL - ALL OTHER PLANS KAISER COMMERCIAL - ALL OTHER PLANS $368.08 ↑ +419%
NETWORKS BY DESIGN- ALL PLANS NETWORKS BY DESIGN- ALL PLANS $368.08 ↑ +419%
WESTERN GROWERS- ALL PLANS WESTERN GROWERS- ALL PLANS $389.89 ↑ +450%
UHC JLL UHC JLL $390.07 ↑ +450%
UHC HMO UHC HMO $390.07 ↑ +450%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $390.07 ↑ +450%
HEALTHNET- ALL OTHER PLANS HEALTHNET- ALL OTHER PLANS $397.25 ↑ +460%
AETNA - ALL PLANS AETNA - ALL PLANS $412.70 ↑ +482%
BLUE CROSS NON-MCS - ALL OTHER PLANS BLUE CROSS NON-MCS - ALL OTHER PLANS $626.17 ↑ +783%
BLUE CROSS EXCHANGE BLUE CROSS EXCHANGE $731.99 ↑ +932%
THREE RIVERS PROVIDER NETWORK- ALL PLANS THREE RIVERS PROVIDER NETWORK- ALL PLANS $911.70 ↑ +1186%
CCA HEALTH PLAN MCR ADV- ALL PLANS CCA HEALTH PLAN MCR ADV- ALL PLANS $4,372.97 ↑ +6067%
BRIGHT HEALTH - ALL PLANS BRIGHT HEALTH - ALL PLANS $8,745.94 ↑ +12234%

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Mouth vestibule bx/w complex rpr 40814 at other California hospitals

Hospital City Cash price Negotiated range
Fresno Medical Center FRESNO $5,398.40 not published
Antioch Medical Center ANTIOCH $5,398.40 not published
Redwood City Medical Center Redwood City $5,398.40 not published
Santa Clara Medical Center SANTA CLARA $5,398.40 not published
Fremont Medical Center FREMONT $5,398.40 not published
Sacramento Medical Center SACRAMENTO $5,398.40 not published
Oakland Medical Center Oakland $5,398.40 not published
Walnut Creek Medical Center WALNUT CREEK $5,398.40 not published

All California hospitals for this procedure →