Subsequent intensive care infant 2501-5000 grams 99480 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

$20.30

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.

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

$290.00

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.

$73.06 with MEDCORE(OMNI IPA) OP ONLY- ALL PLANS vs $304.00 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
MEDCORE(OMNI IPA) OP ONLY- ALL PLANS MEDCORE(OMNI IPA) OP ONLY- ALL PLANS $73.06 ↑ +260%
BLUE SHIELD EPN - ALL OTHER PLANS BLUE SHIELD EPN - ALL OTHER PLANS $91.04 ↑ +348%
BLUE SHIELD NON-EPN BLUE SHIELD NON-EPN $94.42 ↑ +365%
MEDI-CAL MEDI-CAL $98.63 ↑ +386%
BC MCAL BC MCAL $98.63 ↑ +386%
KAISER MCAL KAISER MCAL $98.63 ↑ +386%
CELTIC INS COMPANY - ALL PLANS CELTIC INS COMPANY - ALL PLANS $98.63 ↑ +386%
UHC MCR ADV UHC MCR ADV $101.78 ↑ +401%
TRICARE BLUE SHIELD - ALL PLANS TRICARE BLUE SHIELD - ALL PLANS $101.78 ↑ +401%
KNNEX HEALTH - ALL PLANS KNNEX HEALTH - ALL PLANS $101.78 ↑ +401%
ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS $101.78 ↑ +401%
BLUE SHIELD MCARE ADV BLUE SHIELD MCARE ADV $101.78 ↑ +401%
HEALTHNET MCARE HEALTHNET MCARE $101.78 ↑ +401%
HP OF SAN JOAQUIN MCR ADV HP OF SAN JOAQUIN MCR ADV $101.78 ↑ +401%
HUMANA MCR ADV - ALL PLANS HUMANA MCR ADV - ALL PLANS $101.78 ↑ +401%
HP HEALTHY KIDS PRO FEE HP HEALTHY KIDS PRO FEE $106.87 ↑ +426%
HP MCAL PRO FEE HP MCAL PRO FEE $108.49 ↑ +434%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $111.96 ↑ +452%
AETNA - ALL PLANS AETNA - ALL PLANS $114.48 ↑ +464%
KAISER COMMERCIAL - ALL OTHER PLANS KAISER COMMERCIAL - ALL OTHER PLANS $115.21 ↑ +468%
HEALTHNET MCAL HEALTHNET MCAL $118.36 ↑ +483%
HP OF SAN JOAQUIN MCAL HP OF SAN JOAQUIN MCAL $118.36 ↑ +483%
FIRST HEALTH- ALL PLANS FIRST HEALTH- ALL PLANS $122.14 ↑ +502%
HP OF SAN JOAQUIN PPO - ALL OTHER PLANS HP OF SAN JOAQUIN PPO - ALL OTHER PLANS $132.31 ↑ +552%
BEECH STREET- ALL PLANS BEECH STREET- ALL PLANS $132.31 ↑ +552%
MULTIPLAN- ALL PLANS MULTIPLAN- ALL PLANS $132.31 ↑ +552%
CIGNA- ALL PLANS CIGNA- ALL PLANS $137.08 ↑ +575%
NETWORKS BY DESIGN- ALL PLANS NETWORKS BY DESIGN- ALL PLANS $137.40 ↑ +577%
KAISER MCR ADV KAISER MCR ADV $137.40 ↑ +577%
HEALTHNET- ALL OTHER PLANS HEALTHNET- ALL OTHER PLANS $138.00 ↑ +580%
WESTERN GROWERS- ALL PLANS WESTERN GROWERS- ALL PLANS $145.55 ↑ +617%
CCA HEALTH PLAN MCR ADV- ALL PLANS CCA HEALTH PLAN MCR ADV- ALL PLANS $155.04 ↑ +664%
UHC JLL UHC JLL $156.77 ↑ +672%
UHC HMO UHC HMO $156.77 ↑ +672%
UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $156.77 ↑ +672%
BLUE CROSS EXCHANGE BLUE CROSS EXCHANGE $180.80 ↑ +791%
BLUE CROSS NON-MCS - ALL OTHER PLANS BLUE CROSS NON-MCS - ALL OTHER PLANS $200.89 ↑ +890%
THREE RIVERS PROVIDER NETWORK- ALL PLANS THREE RIVERS PROVIDER NETWORK- ALL PLANS $252.90 ↑ +1146%
BRIGHT HEALTH - ALL PLANS BRIGHT HEALTH - ALL PLANS $304.00 ↑ +1398%

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Subsequent intensive care infant 2501-5000 grams 99480 at other California hospitals

Hospital City Cash price Negotiated range
REEDLEY COMMUNITY HOSPITAL Reedley $53.39 $3.38 – $619.49
HANFORD COMMUNITY HOSPITAL Selma $53.39 $98.63 – $233.43
SAN JOAQUIN COMMUNITY HOSPITAL Bakersfield $42.15 $98.63 – $221.00
ADVENTIST HEALTH MENDOCINO COAST Fort Bragg $185.46 $98.63 – $181.30
WILLITS HOSPITAL INC Willits $84.30 $98.63 – $221.35
SONORA COMMUNITY HOSPITAL Sonora $47.77 $98.63 – $221.35
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi $75.87 $98.63 – $523.31
ADVENTIST HEALTH TULARE Tulare $53.39 $98.63 – $191.21

All California hospitals for this procedure →