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 |
|---|---|---|---|---|
| Creatine kinase isoenzymes CPT 82552 | $0.94 | $13.39 | $4.93 – $147.24 | 23 |
| Creatine kinase mb CPT 82553 | $48.93 | $699.00 | $4.21 – $126.96 | 23 |
| Creatine - sendout CPT 82540 | $2.93 | $41.88 | $1.46 – $50.49 | 23 |
| Creatinine CPT 82565 | $41.93 | $599.00 | $1.46 – $56.26 | 23 |
| Creatinine 24 hour urine CPT 82570 | $41.79 | $597.00 | $1.46 – $56.85 | 23 |
| Creatinine clearance urine CPT 82575 | $59.71 | $853.00 | $3.35 – $103.71 | 23 |
| #creutz-prot.,western blot CPT 84182 | $11.20 | $160.00 | $6.68 – $197.87 | 23 |
| Cricopharyngeal myotomy 43030 CPT 43030 | $127.54 | $1,822.00 | $20.00 – $958.62 | 34 |
| Crisis psychotherapy 90839 CPT 90839 | $26.53 | $379.00 | $52.34 – $468.22 | 36 |
| Crisis psychotherapy additional 30 mins 90840 CPT 90840 | $13.02 | $186.00 | $18.98 – $135.11 | 36 |
| Critical care 30-74 minutes CPT 99291 | $895.16 | $12,788.00 | $121.60 – $466.46 | 36 |
| Critical care each additional 30 minutes CPT 99292 | $336.42 | $4,806.00 | $58.90 – $210.25 | 36 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | $177.10 | $2,530.00 | $717.78 – $1,435.56 | 36 |
| Crutches underarm other than wood adjustable or e0114 HCPCS E0114 | $11.13 | $159.00 | $21.94 – $134.52 | 34 |
| Cryocautery of cervix 57511 CPT 57511 | $48.86 | $698.00 | $6.00 – $305.21 | 36 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $0.65 | $9.34 | $3.08 – $94.31 | 23 |
| Cryoprecipitate each unit HCPCS P9012 | $25.48 | $364.00 | $59.15 – $689.00 | 20 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | $36.82 | $526.00 | $69.62 – $304.00 | 36 |
| Cryotherapy of acne 17340 CPT 17340 | $12.95 | $185.00 | $37.23 – $155.62 | 36 |
| Cryptosporidium antigen CPT 87272 | $0.84 | $11.98 | $3.18 – $98.83 | 23 |
| Crystal identification light microscopy CPT 89060 | $49.91 | $713.00 | $7.33 – $78.54 | 24 |
| C-Section Delivery (full care) CPT 59510 | $623.00 | $8,900.00 | $1,390.97 – $3,631.02 | 33 |
| C-section delivery incl p/p care 59515 CPT 59515 | $305.90 | $4,370.00 | $95.00 – $2,448.97 | 34 |
| Csf leakage imaging CPT 78650 | $267.19 | $3,817.00 | $24.25 – $432.71 | 34 |
| CT 3d report other modality w/workstation CPT 76377 | $62.16 | $888.00 | $28.60 – $1,006.49 | 37 |
| Cta abdomen without & /or w/contrast CPT 74175 | $752.57 | $10,751.00 | $47.32 – $2,430.24 | 37 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $899.22 | $12,846.00 | $62.28 – $2,430.24 | 37 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,064.84 | $15,212.00 | $49.48 – $2,133.30 | 37 |
| Cta neck without &/or w/contrast CPT 70498 | $813.26 | $11,618.00 | $45.84 – $2,067.08 | 37 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $1,048.88 | $14,984.00 | $57.34 – $3,561.72 | 37 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $890.33 | $12,719.00 | $47.70 – $2,528.25 | 37 |
| CT Angiogram of the Head CPT 70496 | $876.54 | $12,522.00 | $45.84 – $2,067.08 | 37 |
| CT angio hrt w/3d image CPT 75574 | $31.08 | $444.00 | $62.06 – $374.56 | 34 |
| CT angio pelvis CPT 72191 | $23.24 | $332.00 | $47.24 – $489.98 | 34 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $945.00 | $13,500.00 | $46.94 – $2,133.30 | 37 |
| CT bone density axial CPT 77078 | $3.22 | $46.00 | $6.45 – $101.90 | 34 |
| CT cerebral perf w cont & prcssng CPT 70473 | $47.81 | $683.00 | $48.22 – $1,037.34 | 19 |
| CT colonography screening CPT 74263 | $31.36 | $448.00 | $59.70 – $939.93 | 27 |
| CT guidance for needle placement CPT 77012 | $666.68 | $9,524.00 | $65.62 – $2,324.58 | 36 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $15.05 | $215.00 | $55.11 – $886.90 | 37 |
| CT guid cryo ablat intramuscular CPT 20999 | $102.97 | $1,471.00 | $38.00 – $304.00 | 14 |
| CT guid parench tis ablat CPT 77013 | $666.68 | $9,524.00 | $70.86 – $2,441.30 | 34 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $7.56 | $108.00 | $15.05 – $97.60 | 34 |
| CT hrt w/3d image CPT 75572 | $22.54 | $322.00 | $45.34 – $302.91 | 34 |
| CT limited or localized follow-up study CPT 76380 | $12.32 | $176.00 | $25.63 – $164.09 | 34 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $879.83 | $12,569.00 | $30.41 – $1,659.94 | 37 |
| CT lower extremity without contrast (both sides) CPT 73700 | $663.53 | $9,479.00 | $26.20 – $1,395.91 | 37 |
| CT lwr extremity w/o&w/dye CPT 73702 | $616.00 | $8,800.00 | $31.90 – $2,083.00 | 37 |
| CT neck soft tissue w/contrast CPT 70491 | $691.46 | $9,878.00 | $36.30 – $1,595.25 | 37 |
| CT neck soft tissue without contrast CPT 70490 | $597.17 | $8,531.00 | $33.58 – $1,332.95 | 37 |
| CT neck soft tissue without & w/contrast CPT 70492 | $687.75 | $9,825.00 | $37.97 – $1,988.53 | 37 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $754.60 | $10,780.00 | $37.78 – $1,988.53 | 37 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $622.65 | $8,895.00 | $36.11 – $1,595.25 | 37 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $565.32 | $8,076.00 | $33.58 – $1,332.95 | 37 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $94.36 | $1,348.00 | $8.00 – $405.00 | 36 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $1,421.77 | $20,311.00 | $52.66 – $2,495.93 | 37 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $1,205.82 | $17,226.00 | $47.70 – $1,887.92 | 37 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $1,029.21 | $14,703.00 | $45.65 – $989.37 | 37 |
| CT thoracic spine w/contrast CPT 72129 | $822.50 | $11,750.00 | $32.09 – $1,984.53 | 37 |
| CT thoracic spine without contrast CPT 72128 | $711.83 | $10,169.00 | $26.20 – $1,659.94 | 37 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $58.10 | $830.00 | $27.94 – $768.55 | 37 |
| CT t-spine w /wo contrast CPT 72130 | $890.40 | $12,720.00 | $33.20 – $2,472.88 | 37 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $606.97 | $8,671.00 | $30.41 – $1,659.94 | 37 |
| CT upper extremity without contrast (both sides) CPT 73200 | $418.74 | $5,982.00 | $26.20 – $1,395.91 | 37 |
| CT uppr extremity w/o&w/dye CPT 73202 | $647.50 | $9,250.00 | $31.90 – $2,083.00 | 37 |
| Culture aerobic additional method definitive id each CPT 87077 | $18.48 | $264.00 | $1.83 – $88.76 | 23 |
| Culture afb any source CPT 87116 | $61.18 | $874.00 | $2.51 – $118.59 | 23 |
| Culture anaerobic additional method definitive id each CPT 87076 | $20.16 | $288.00 | $4.72 – $138.50 | 23 |
| Culture anaerobic except blood CPT 87075 | $84.56 | $1,208.00 | $3.43 – $104.01 | 23 |
| Culture bact stool aero addl path ea CPT 87046 | $13.02 | $186.00 | $0.72 – $31.35 | 23 |
| Culture body fluid CPT 87070 | $62.30 | $890.00 | $3.10 – $94.61 | 23 |
| Culture fungi definitive id mold CPT 87107 | $25.27 | $361.00 | $2.53 – $113.48 | 23 |
| Culture fungi definitive id yeast CPT 87106 | $23.31 | $333.00 | $3.76 – $113.48 | 23 |
| Culture fungi other (except blood) CPT 87102 | $62.58 | $894.00 | $2.51 – $92.39 | 23 |
| Culture fungi skin/hair/nail CPT 87101 | $33.95 | $485.00 | $2.09 – $84.76 | 23 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $3.78 | $54.04 | $3.99 – $120.37 | 23 |
| Culture mycoplasma any source CPT 87109 | $3.07 | $43.88 | $5.69 – $169.15 | 23 |
| Culture quantitative aerobic other source CPT 87071 | $0.69 | $9.89 | $1.43 – $51.82 | 23 |
| Culture screening strep group a CPT 87081 | $35.91 | $513.00 | $2.09 – $72.32 | 23 |
| Culture typing added method CPT 87158 | $1.44 | $20.56 | $1.82 – $57.52 | 23 |
| Culture typing immunologic CPT 87147 | $12.46 | $178.00 | $1.25 – $51.45 | 23 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $15.26 | $218.06 | $218.06 – $645.66 | 22 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $2.46 | $35.09 | $6.35 – $453.56 | 23 |
| Culture urine each isolate CPT 87088 | $17.43 | $249.00 | $1.68 – $79.13 | 23 |
| Curette/treat cornea CPT 65435 | $17.08 | $244.00 | $60.35 – $2,629.68 | 36 |
| Curette/treat cornea CPT 65436 | $95.76 | $1,368.00 | $80.00 – $683.48 | 34 |
| Cutter lead HCPCS C1773 | $175.49 | $2,507.00 | $2,089.00 – $2,985.18 | 5 |
| Cv line/pic reposition CPT 36597 | $14.00 | $200.00 | $35.00 – $231.07 | 34 |
| Cv stress test i&r only 93018 CPT 93018 | $3.92 | $56.00 | $14.06 – $234.12 | 37 |
| Cv stress test/supervision only 93016 CPT 93016 | $5.95 | $85.00 | $21.35 – $286.35 | 37 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $1.00 | $14.32 | $5.27 – $157.53 | 23 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $16.19 | $231.27 | $0.64 – $14.40 | 19 |
| Cyclic citrullinated peptide antibody CPT 86200 | $9.87 | $141.00 | $1.96 – $139.24 | 24 |
| Cyclosporine 2 hour CPT 80158 | $1.26 | $18.05 | $5.26 – $198.54 | 23 |
| Cyclosporine oral 100 mg HCPCS J7502 | $5.60 | $80.00 | $2.61 – $114.32 | 10 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $7,619.99 | $108,857.00 | $12,625.00 – $15,781.25 | 4 |
| Cyp2c19 gene com variants CPT 81225 | $9.10 | $130.00 | $90.00 – $1,138.98 | 23 |
| Cyp2c9 gene com variants CPT 81227 | $7.00 | $100.00 | $70.00 – $572.38 | 23 |
| Cyp2d6 gene com variants CPT 81226 | $12.60 | $180.00 | $150.00 – $1,580.40 | 22 |
| Cyp3a4 gene common variants CPT 81230 | $4.90 | $70.00 | $70.00 – $1,375.57 | 22 |
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.