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 |
|---|---|---|---|---|
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $104.30 | $1,490.00 | $152.00 – $587.55 | 36 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $122.08 | $1,744.00 | $45.00 – $790.62 | 36 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $45.08 | $644.00 | $30.00 – $276.18 | 36 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $95.97 | $1,371.00 | $129.19 – $517.15 | 36 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $116.13 | $1,659.00 | $152.00 – $796.03 | 36 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $41.02 | $586.00 | $86.75 – $246.39 | 36 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $30.87 | $441.00 | $41.00 – $184.12 | 36 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $84.42 | $1,206.00 | $110.57 – $454.88 | 36 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $28.42 | $406.00 | $26.00 – $157.04 | 36 |
| Composite byp grft 2 veins CPT 35682 | $76.93 | $1,099.00 | $95.00 – $681.76 | 34 |
| Composite byp grft 3/> segmt CPT 35683 | $89.46 | $1,278.00 | $86.37 – $803.02 | 34 |
| Composite byp grft pros&vein CPT 35681 | $17.43 | $249.00 | $67.11 – $150.99 | 34 |
| Composite graft/pri close/don area 15760 CPT 15760 | $171.01 | $2,443.00 | $65.00 – $1,240.08 | 34 |
| Comprehensive hearing test CPT 92557 | $6.44 | $92.00 | $26.42 – $91.71 | 34 |
| Compre oph exam est pt 1/> CPT 92014 | $22.40 | $320.00 | $38.43 – $304.00 | 36 |
| Compre oph exam new pt 1/> CPT 92004 | $26.39 | $377.00 | $49.78 – $304.00 | 36 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $876.54 | $12,522.00 | $120.19 – $1,608.01 | 22 |
| Concentration infection agents any type CPT 87015 | $12.95 | $185.00 | $2.09 – $73.43 | 23 |
| Condylomata destruction 56420 CPT 56420 | $45.99 | $657.00 | $28.00 – $304.00 | 36 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | $367.08 | $5,244.00 | $60.00 – $555.16 | 36 |
| Conization of cervix CPT 57520 | $72.38 | $1,034.00 | $25.00 – $8,539.30 | 36 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $48.72 | $696.00 | $391.76 – $807.36 | 18 |
| Consultation pathology during surgery CPT 88329 | $9.52 | $136.00 | $19.53 – $286.42 | 36 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $12.91 | $184.44 | $68.89 – $2,125.32 | 24 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $3.50 | $50.00 | $27.81 – $113.34 | 24 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $10.85 | $155.00 | $63.86 – $449.42 | 24 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $10.15 | $145.00 | $50.00 – $196.56 | 24 |
| Consultation with family CPT 90887 | $9.80 | $140.00 | $86.28 – $168.00 | 15 |
| Contact layer >16<= 48 sq in HCPCS A6207 | $1.82 | $26.00 | $3.34 – $31.20 | 32 |
| Contact lens fitting for tx CPT 92071 | $6.37 | $91.00 | $26.62 – $59.34 | 36 |
| Contact lens fitting ou CPT 92310 | $7.00 | $100.00 | $36.00 – $143.48 | 15 |
| Cont gluc mntr analysis i&r 95251 CPT 95251 | $5.95 | $85.00 | $21.45 – $83.01 | 37 |
| Contour of face bone lesion CPT 21029 | $154.35 | $2,205.00 | $50.00 – $8,745.94 | 36 |
| Contrast baths charges CPT 97034 | $8.75 | $125.00 | $11.23 – $499.00 | 25 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $979.23 | $13,989.00 | $62.85 – $8,329.20 | 37 |
| Contrast exam thoracic aorta CPT 75600 | $1,167.25 | $16,675.00 | $23.42 – $8,329.20 | 37 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $14.28 | $204.00 | $51.93 – $228.09 | 34 |
| Contrast x-ray gallbladder CPT 74290 | $4.20 | $60.00 | $14.92 – $76.47 | 34 |
| Contrast x-ray of ankle CPT 73615 | $11.20 | $160.00 | $28.60 – $110.43 | 34 |
| Contrast x-ray of elbow CPT 73085 | $375.27 | $5,361.00 | $25.50 – $920.30 | 37 |
| Contrast x-ray of hip CPT 73525 | $187.46 | $2,678.00 | $28.97 – $920.30 | 37 |
| Contrast x-ray of knee joint CPT 73580 | $238.91 | $3,413.00 | $31.94 – $920.30 | 37 |
| Contrast x-ray of wrist CPT 73115 | $7.63 | $109.00 | $27.51 – $117.82 | 34 |
| Controller infinity pt dbs HCPCS C1787 | $420.00 | $6,000.00 | $74.00 – $7,200.00 | 9 |
| Control nosebleed pack+caut 30905 CPT 30905 | $87.01 | $1,243.00 | $8.00 – $350.26 | 36 |
| Control nose/throat bleeding with surg ivntj 42972 CPT 42972 | $123.62 | $1,766.00 | $65.00 – $941.25 | 34 |
| Control of nosebleed ant comp 30903 CPT 30903 | $60.41 | $863.00 | $28.00 – $304.00 | 36 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $38.99 | $557.00 | $13.00 – $304.00 | 36 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $39.48 | $564.00 | $45.00 – $1,422.71 | 36 |
| Control throat bleeding CPT 42961 | $103.18 | $1,474.00 | $20.00 – $758.69 | 36 |
| Control throat bleeding CPT 42962 | $126.91 | $1,813.00 | $40.00 – $938.88 | 34 |
| Conversion ext bil drg cath CPT 47535 | $45.50 | $650.00 | $167.40 – $3,812.41 | 34 |
| Convert nephrostomy catheter CPT 50434 | $585.90 | $8,370.00 | $60.00 – $5,514.28 | 36 |
| Conv gtube to jtube CPT 44373 | $45.29 | $647.00 | $50.00 – $512.99 | 34 |
| Coombs direct CPT 86880 | $34.09 | $487.00 | $1.87 – $59.07 | 23 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $0.70 | $10.00 | $2.00 – $62.92 | 23 |
| Coombs indirect titer reference CPT 86886 | $17.01 | $243.00 | $1.79 – $56.85 | 23 |
| Copper intrauterine device HCPCS J7300 | $142.52 | $2,036.00 | $168.42 – $2,443.20 | 19 |
| Core ndl bx lng/med perq CPT 32408 | $419.30 | $5,990.00 | $17.00 – $4,356.78 | 36 |
| Cor hlx vlgs double osteot CPT 28299 | $147.14 | $2,102.00 | $552.49 – $1,582.02 | 34 |
| Cor hlx vlgs dstl mtar osteo CPT 28296 | $127.61 | $1,823.00 | $70.00 – $1,369.11 | 34 |
| Cor hlx vlgs prx phlx osteot CPT 28298 | $125.16 | $1,788.00 | $295.23 – $1,210.10 | 34 |
| Corneal smear CPT 65430 | $24.71 | $353.00 | $30.00 – $1,178.42 | 36 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $946.33 | $13,519.00 | $317.95 – $8,551.98 | 36 |
| Coronary angio/lv gram/lt heart CPT 93458 | $1,395.94 | $19,942.00 | $280.22 – $8,551.98 | 36 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $1,855.42 | $26,506.00 | $355.33 – $8,551.98 | 36 |
| Coronary art/grft angio s&i CPT 93455 | $1,858.85 | $26,555.00 | $265.10 – $8,551.98 | 36 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $1,347.92 | $19,256.00 | $227.56 – $8,551.98 | 36 |
| Correct bunion/keller/mcbride/mayo 28292 CPT 28292 | $120.96 | $1,728.00 | $295.23 – $1,282.87 | 34 |
| Correct finger deformity CPT 26567 | $179.20 | $2,560.00 | $30.00 – $8,631.30 | 36 |
| Correct inverted nipple(s) CPT 19355 | $150.78 | $2,154.00 | $61.97 – $10,328.62 | 36 |
| Correction hallux valgus sesamoidectomy;prox meta osteotomy CPT 28295 | $147.70 | $2,110.00 | $171.26 – $2,519.92 | 34 |
| Correction trichiasis epilation forcep 67820 CPT 67820 | $5.53 | $79.00 | $19.31 – $304.00 | 36 |
| Correct malrotation of bowel 44055 CPT 44055 | $346.71 | $4,953.00 | $40.00 – $2,581.91 | 34 |
| Correct metacarpal flaw CPT 26565 | $177.73 | $2,539.00 | $60.00 – $1,416.62 | 34 |
| Correct rectal prolapse CPT 45541 | $224.07 | $3,201.00 | $60.00 – $1,557.20 | 34 |
| Correct rectal prolapse; abdominal approach 45540 CPT 45540 | $248.78 | $3,554.00 | $40.00 – $1,837.72 | 34 |
| Corrj halux rigdus w/implt CPT 28291 | $117.67 | $1,681.00 | $132.17 – $19,141.34 | 36 |
| Corrj halux rigdus without implt CPT 28289 | $170.66 | $2,438.00 | $152.00 – $1,258.61 | 36 |
| Cortisol acth stimulation test - sendout CPT 80400 | $41.93 | $599.00 | $8.98 – $358.81 | 23 |
| Cortisol total am CPT 82533 | $36.40 | $520.00 | $6.03 – $179.44 | 23 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $143.21 | $2,045.80 | $36.06 – $2,923.45 | 11 |
| Co-treatment - group 15 mins, st CPT 92508 | $49.14 | $702.00 | $25.30 – $499.00 | 25 |
| Counseling smoke cess interm >10mins CPT 99407 | $6.86 | $98.00 | $19.93 – $98.84 | 36 |
| Counseling visit to discuss need for ldct g0296 HCPCS G0296 | $7.77 | $111.00 | $0.01 – $420.66 | 35 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $63.00 | $900.00 | $900.00 – $1,125.00 | 4 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $9.24 | $132.00 | $12.00 – $107.20 | 28 |
| #covid19rsv-rsv CPT 87634 | $52.57 | $751.00 | $17.19 – $613.74 | 36 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $0.91 | $13.03 | $4.79 – $145.02 | 23 |
| C-peptide CPT 84681 | $3.27 | $46.75 | $7.19 – $186.47 | 23 |
| Cptr-asst dir ms px CPT 20985 | $33.81 | $483.00 | $65.00 – $246.78 | 36 |
| Cptrized corneal topography CPT 92025 | $6.51 | $93.00 | $29.55 – $304.00 | 18 |
| Cptr ophth dx img post segmt CPT 92134 | $5.81 | $83.00 | $18.40 – $155.62 | 36 |
| Crbrospnl fld flw imag cistern CPT 78630 | $340.76 | $4,868.00 | $31.19 – $1,432.31 | 37 |
| C-reactive protein CPT 86140 | $27.51 | $393.00 | $1.79 – $56.85 | 23 |
| C-reactive protein high sensitivity CPT 86141 | $28.91 | $413.00 | $3.04 – $142.28 | 23 |
| C-reactive protein, quantitative CPT 86406 | $0.74 | $10.64 | $3.87 – $178.11 | 23 |
| Creat artery-vein fistula autograft 36825 CPT 36825 | $178.29 | $2,547.00 | $618.02 – $14,678.70 | 36 |
| Create eardrum opening CPT 69436 | $59.29 | $847.00 | $64.00 – $275.03 | 34 |
| Creatine kinase CPT 82550 | $41.58 | $594.00 | $2.31 – $72.10 | 23 |
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.