LODI MEMORIAL HOSPITAL ASSOCIATION INC
975 S Fairmont Ave, Lodi, CA · Adventisthealth · · NPI 1316938301
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $86.24 | $1,232.00 | $152.00 – $578.99 | 35 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $110.60 | $1,580.00 | $373.29 – $4,241.76 | 35 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $70.00 | $1,000.00 | $152.00 – $465.09 | 35 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $74.13 | $1,059.00 | $8.00 – $650.69 | 36 |
| Clsd tx wrist carpal fx without manip 25630 CPT 25630 | $79.80 | $1,140.00 | $152.00 – $562.38 | 35 |
| Clsd tx wrist scaphoid fx without manip 25622 CPT 25622 | $80.85 | $1,155.00 | $152.00 – $548.14 | 36 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $85.68 | $1,224.00 | $152.00 – $586.11 | 36 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $76.65 | $1,095.00 | $152.00 – $529.16 | 35 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $103.04 | $1,472.00 | $325.35 – $727.68 | 36 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $114.31 | $1,633.00 | $236.04 – $4,241.76 | 36 |
| Cltx hum epcndylr fx wo mnpj CPT 24560 | $86.87 | $1,241.00 | $152.00 – $578.99 | 36 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $128.73 | $1,839.00 | $15.00 – $4,241.76 | 36 |
| Cltx humrl cndylr fx wo mnpj CPT 24576 | $81.62 | $1,166.00 | $15.00 – $650.69 | 36 |
| Cltx lunate dislc w/mnpj CPT 25690 | $124.39 | $1,777.00 | $17.00 – $889.84 | 34 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $231.00 | $3,300.00 | $337.30 – $1,423.74 | 34 |
| Cltx post ankle fx CPT 27767 | $76.30 | $1,090.00 | $15.00 – $519.67 | 36 |
| Cltx post ankle fx w/mnpj CPT 27768 | $113.75 | $1,625.00 | $58.45 – $4,241.76 | 36 |
| Cltx strnclav dislc w/mnpj CPT 23525 | $93.73 | $1,339.00 | $35.00 – $652.55 | 34 |
| Cmbn ant pst colprhy CPT 57260 | $185.71 | $2,653.00 | $121.61 – $13,196.08 | 36 |
| Cmptr ophth dx img ant segmt CPT 92132 | $5.32 | $76.00 | $15.91 – $155.62 | 36 |
| Cmptr ophth img optic nerve CPT 92133 | $5.46 | $78.00 | $16.96 – $155.62 | 36 |
| #cmvcul-virus inoculation shell CPT 87254 | $1.70 | $24.34 | $1.49 – $64.97 | 23 |
| Cmv pcr-sendout CPT 87496 | $4.59 | $65.51 | $12.31 – $373.39 | 23 |
| Co2 monitor per day CPT 94681 | $46.62 | $666.00 | $9.90 – $984.36 | 37 |
| Coagulation time activated teg CPT 85347 | $65.66 | $938.00 | $1.45 – $46.79 | 23 |
| Cold agglutinin screen (arc) CPT 86156 | $3.85 | $55.00 | $2.35 – $73.06 | 23 |
| Cold agglutinin titer CPT 86157 | $0.56 | $8.06 | $2.89 – $88.68 | 23 |
| Colectomy/end colost/close dis seg 44143 CPT 44143 | $384.02 | $5,486.00 | $35.00 – $2,871.16 | 34 |
| Colectomy/ ileostomy without prctect 44150 CPT 44150 | $433.79 | $6,197.00 | $219.28 – $3,143.81 | 34 |
| Colectomy/ ileostomy w/prctect 44155 CPT 44155 | $483.91 | $6,913.00 | $61.00 – $3,537.38 | 34 |
| Colectomy partial w/anastomosis 44140 CPT 44140 | $313.39 | $4,477.00 | $65.00 – $2,342.45 | 34 |
| Colectomy prtl abdominal + transanal appr 44147 CPT 44147 | $448.91 | $6,413.00 | $1,703.59 – $3,155.67 | 27 |
| Colectomy prtl w/coloproctostomy 44145 CPT 44145 | $384.65 | $5,495.00 | $643.00 – $2,937.55 | 34 |
| Colectomy prtl w/coloproctostomy + colostomy 44146 CPT 44146 | $489.30 | $6,990.00 | $80.00 – $3,582.43 | 34 |
| Colectomy prtl w/remove terminal ileum+ileocolos 44160 CPT 44160 | $290.36 | $4,148.00 | $95.00 – $2,145.66 | 34 |
| Colectomy prtl w/skin level cecost/colostomy 44141 CPT 44141 | $422.10 | $6,030.00 | $707.00 – $2,975.48 | 34 |
| Colectomy/w colostomy or ileostomy 44144 CPT 44144 | $410.27 | $5,861.00 | $80.00 – $2,954.14 | 34 |
| Collagenase, clost hist inj HCPCS J0775 | $16.94 | $242.00 | $75.75 – $280.72 | 18 |
| Collagen dressing <=16 sq in HCPCS A6021 | $5.11 | $73.00 | $9.55 – $87.60 | 32 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $11.06 | $158.00 | $14.92 – $116.00 | 34 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $18.13 | $259.00 | $55.30 – $147.12 | 17 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $37.45 | $535.00 | $48.20 – $304.00 | 20 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $41.65 | $595.00 | $48.20 – $940.10 | 20 |
| Collection of venous blood by venipuncture CPT 36415 | $6.37 | $91.00 | $1.37 – $20.25 | 37 |
| Colonoscopy (diagnostic) CPT 45378 | $105.28 | $1,504.00 | $50.00 – $2,453.16 | 36 |
| Colonoscopy flex with decompression 45393 CPT 45393 | $58.80 | $840.00 | $35.00 – $898.98 | 34 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $136.08 | $1,944.00 | $201.05 – $3,156.66 | 36 |
| Colonoscopy & polypectomy 44392 CPT 44392 | $46.69 | $667.00 | $25.00 – $708.30 | 34 |
| Colonoscopy stoma w/endo mucosal rescj 44403 CPT 44403 | $71.47 | $1,021.00 | $74.00 – $486.44 | 27 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | $52.99 | $757.00 | $20.00 – $798.86 | 34 |
| Colonoscopy submucous njx CPT 45381 | $47.39 | $677.00 | $15.00 – $3,156.66 | 36 |
| Colonoscopy thru stoma spx CPT 44388 | $36.82 | $526.00 | $50.00 – $569.40 | 34 |
| Colonoscopy w/ablation CPT 45388 | $63.49 | $907.00 | $30.00 – $3,156.66 | 36 |
| Colonoscopy w/balloon dilat CPT 45386 | $49.98 | $714.00 | $15.00 – $1,079.66 | 34 |
| Colonoscopy w/band ligation CPT 45398 | $55.09 | $787.00 | $30.00 – $1,108.43 | 34 |
| Colonoscopy w/control bleed CPT 45382 | $162.61 | $2,323.00 | $30.00 – $1,020.71 | 36 |
| Colonoscopy w/decompression CPT 44408 | $54.60 | $780.00 | $74.00 – $371.58 | 27 |
| Colonoscopy w/dilation CPT 44405 | $43.40 | $620.00 | $55.00 – $874.27 | 34 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | $60.76 | $868.00 | $169.77 – $532.32 | 34 |
| Colonoscopy w/endoscopic fnb CPT 45392 | $71.54 | $1,022.00 | $214.82 – $669.27 | 34 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | $68.04 | $972.00 | $10.00 – $620.67 | 34 |
| Colonoscopy w/fb removal CPT 45379 | $56.21 | $803.00 | $35.00 – $897.57 | 34 |
| Colonoscopy w/injection CPT 44404 | $40.53 | $579.00 | $20.00 – $584.54 | 34 |
| Colonoscopy with ablation CPT 44401 | $57.05 | $815.00 | $74.00 – $799.67 | 27 |
| Colonoscopy (with biopsy) CPT 45380 | $136.08 | $1,944.00 | $10.00 – $3,156.66 | 36 |
| Colonoscopy with biopsy CPT 44389 | $101.57 | $1,451.00 | $20.00 – $639.04 | 34 |
| Colonoscopy (with polyp removal) CPT 45385 | $136.08 | $1,944.00 | $223.60 – $3,156.66 | 36 |
| Colonoscopy w/ndl aspir/bx CPT 44407 | $64.82 | $926.00 | $74.00 – $441.48 | 27 |
| Colonoscopy w/resection CPT 45390 | $78.12 | $1,116.00 | $10.00 – $996.17 | 34 |
| Colonoscopy w/stent plcmt CPT 44402 | $61.53 | $879.00 | $50.00 – $415.23 | 34 |
| Colonoscopy w/ultrasound CPT 44406 | $54.11 | $773.00 | $74.00 – $368.20 | 27 |
| Colostomy skin level cecostomy 44320 CPT 44320 | $281.89 | $4,027.00 | $20.00 – $2,062.68 | 34 |
| Colotomy exploration/bx/foreign body removal 44025 CPT 44025 | $230.16 | $3,288.00 | $594.56 – $1,695.19 | 34 |
| Colpocleisis (le forte type) 57120 CPT 57120 | $127.96 | $1,828.00 | $121.61 – $1,062.96 | 34 |
| Colpopexy abdominal approach 57280 CPT 57280 | $230.16 | $3,288.00 | $60.00 – $2,004.90 | 34 |
| Colpopexy extraperitoneal CPT 57282 | $166.04 | $2,372.00 | $69.92 – $1,044.55 | 34 |
| Colpopexy intraperitoneal CPT 57283 | $167.09 | $2,387.00 | $364.32 – $1,436.58 | 34 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $81.13 | $1,159.00 | $52.00 – $602.52 | 34 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $43.33 | $619.00 | $20.00 – $334.15 | 36 |
| Colposcopy/cervix/ conization 57461 CPT 57461 | $84.98 | $1,214.00 | $152.00 – $749.86 | 36 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $30.94 | $442.00 | $51.68 – $304.00 | 36 |
| Colposcopy vulva 56820 CPT 56820 | $30.73 | $439.00 | $55.00 – $304.00 | 36 |
| Colposcopy vulva w/biopsy 56821 CPT 56821 | $40.88 | $584.00 | $55.00 – $313.10 | 36 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $39.41 | $563.00 | $60.00 – $305.21 | 36 |
| Colpotomy drng of abscess 57010 CPT 57010 | $110.46 | $1,578.00 | $229.54 – $881.42 | 34 |
| Colpotomy w/exploration 57000 CPT 57000 | $48.72 | $696.00 | $37.00 – $394.67 | 34 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $55.23 | $789.00 | $13.78 – $449.42 | 18 |
| Compatibility test each unit electronic CPT 86923 | $31.43 | $449.00 | $1.40 – $449.42 | 18 |
| Compatibility test each unit immediate spin technique CPT 86920 | $17.01 | $243.00 | $13.78 – $449.42 | 18 |
| Compatibility test incubate CPT 86921 | $57.89 | $827.00 | $13.78 – $449.42 | 18 |
| Comp cystometrogram/void presssure 51728 CPT 51728 | $85.82 | $1,226.00 | $105.04 – $317.49 | 36 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $90.30 | $1,290.00 | $45.00 – $328.52 | 36 |
| Complement antigen each component c3 CPT 86160 | $8.89 | $127.00 | $4.39 – $131.99 | 23 |
| Complement fixation each CPT 86171 | $0.70 | $10.01 | $3.64 – $110.15 | 23 |
| Complete removal of vulva CPT 56625 | $161.98 | $2,314.00 | $152.01 – $8,539.30 | 36 |
| Complex cystometrogram 51726 CPT 51726 | $70.21 | $1,003.00 | $57.66 – $304.00 | 18 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $87.85 | $1,255.00 | $26.00 – $471.12 | 36 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $98.14 | $1,402.00 | $46.00 – $552.35 | 36 |
| Complex uroflowmetry (electronic) 51741 CPT 51741 | $3.50 | $50.00 | $8.70 – $304.00 | 36 |
| Compl oph exam general anes CPT 92018 | $24.36 | $348.00 | $47.88 – $224.15 | 34 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.