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 |
|---|---|---|---|---|
| Cyp3a5 gene common variants CPT 81231 | $4.90 | $70.00 | $70.00 – $1,375.57 | 22 |
| Cystatin c CPT 82610 | $1.30 | $18.52 | $4.08 – $149.53 | 23 |
| Cystic fibrosis cftr CPT 81223 | $87.05 | $1,243.57 | $499.00 – $8,074.50 | 23 |
| Cystine urine quantitative CPT 82131 | $1.61 | $22.98 | $6.21 – $184.48 | 23 |
| Cysto cgen post urtl valves CPT 52400 | $114.03 | $1,629.00 | $100.89 – $946.98 | 34 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $169.61 | $2,423.00 | $15.28 – $920.30 | 37 |
| Cystometrogram w/up 51727 CPT 51727 | $86.10 | $1,230.00 | $133.54 – $414.12 | 18 |
| Cystorrhaphy wound comp 51865 CPT 51865 | $213.71 | $3,053.00 | $60.00 – $1,611.46 | 36 |
| Cystorrhaphy wound simple 51860 CPT 51860 | $178.01 | $2,543.00 | $55.00 – $24,971.80 | 36 |
| Cysto rx balo cath urtl strx CPT 52284 | $38.92 | $556.00 | $60.00 – $14,144.02 | 35 |
| Cystoscopy and biopsy CPT 52007 | $39.41 | $563.00 | $65.00 – $1,157.42 | 34 |
| Cystoscopy and treatment CPT 52214 | $44.73 | $639.00 | $149.52 – $9,298.64 | 36 |
| Cystoscopy and treatment CPT 52224 | $47.39 | $677.00 | $153.76 – $9,298.64 | 36 |
| Cystoscopy and treatment CPT 52234 | $401.03 | $5,729.00 | $30.00 – $9,298.64 | 36 |
| Cystoscopy and treatment CPT 52235 | $401.03 | $5,729.00 | $252.24 – $9,298.64 | 36 |
| Cystoscopy and treatment CPT 52240 | $595.21 | $8,503.00 | $35.00 – $14,144.02 | 36 |
| Cystoscopy and treatment CPT 52260 | $49.63 | $709.00 | $65.00 – $5,514.28 | 36 |
| Cystoscopy and treatment CPT 52265 | $38.36 | $548.00 | $109.83 – $957.50 | 34 |
| Cystoscopy and treatment CPT 52276 | $236.46 | $3,378.00 | $231.44 – $5,514.28 | 36 |
| Cystoscopy and treatment CPT 52277 | $76.02 | $1,086.00 | $65.00 – $570.82 | 34 |
| Cystoscopy and treatment CPT 52283 | $47.81 | $683.00 | $30.00 – $505.06 | 34 |
| Cystoscopy and treatment CPT 52285 | $81.90 | $1,170.00 | $65.00 – $505.06 | 36 |
| Cystoscopy and treatment CPT 52290 | $57.54 | $822.00 | $65.00 – $426.14 | 34 |
| Cystoscopy and treatment CPT 52300 | $65.94 | $942.00 | $65.00 – $494.53 | 34 |
| Cystoscopy and treatment CPT 52310 | $236.46 | $3,378.00 | $35.00 – $478.75 | 36 |
| Cystoscopy and treatment CPT 52315 | $64.61 | $923.00 | $239.86 – $5,514.28 | 36 |
| Cystoscopy and treatment CPT 52320 | $58.03 | $829.00 | $30.00 – $9,298.64 | 36 |
| Cystoscopy and treatment CPT 52330 | $61.95 | $885.00 | $65.00 – $2,514.76 | 34 |
| Cystoscopy (Bladder Scope) CPT 52000 | $78.61 | $1,123.00 | $35.00 – $365.64 | 36 |
| Cystoscopy chemodenervation CPT 52287 | $91.21 | $1,303.00 | $35.00 – $747.06 | 36 |
| Cystoscopy inject material CPT 52327 | $60.55 | $865.00 | $60.00 – $2,149.12 | 34 |
| Cystoscopy removal of clots CPT 52001 | $102.90 | $1,470.00 | $35.00 – $691.82 | 36 |
| Cystoscopy & revise urethra CPT 52275 | $58.66 | $838.00 | $198.06 – $5,514.28 | 36 |
| Cystoscopy stone removal CPT 52325 | $75.11 | $1,073.00 | $35.00 – $565.56 | 34 |
| Cystoscopy & ureter catheter CPT 52005 | $31.78 | $454.00 | $65.00 – $5,514.28 | 36 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $71.61 | $1,023.00 | $277.05 – $5,514.28 | 36 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | $114.59 | $1,637.00 | $439.24 – $778.63 | 34 |
| Cystouretero & or pyeloscope CPT 52351 | $71.26 | $1,018.00 | $260.61 – $9,298.64 | 36 |
| Cysto/uretero stricture tx CPT 52344 | $86.87 | $1,241.00 | $60.00 – $9,298.64 | 36 |
| Cystouretero w/biopsy CPT 52354 | $595.21 | $8,503.00 | $60.00 – $14,144.02 | 36 |
| Cystouretero w/excise tumor CPT 52355 | $109.76 | $1,568.00 | $35.00 – $818.09 | 34 |
| Cysto/uretero w/lithotripsy CPT 52356 | $97.58 | $1,394.00 | $60.00 – $14,144.02 | 36 |
| Cystouretero w/lithotripsy CPT 52353 | $92.05 | $1,315.00 | $35.00 – $739.17 | 34 |
| Cystouretero w/stone remove CPT 52352 | $83.37 | $1,191.00 | $35.00 – $9,298.64 | 36 |
| Cysto/uretero w/up stricture CPT 52345 | $92.61 | $1,323.00 | $30.00 – $9,298.64 | 36 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $76.37 | $1,091.00 | $126.58 – $612.91 | 36 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $33.60 | $480.00 | $30.00 – $5,514.28 | 36 |
| Cystourethro w/addl implant 52442 CPT 52442 | $11.90 | $170.00 | $30.00 – $3,535.39 | 36 |
| Cystourethro w/implant CPT 52441 | $49.42 | $706.00 | $30.00 – $4,537.61 | 36 |
| Cysto w/up stricture tx CPT 52342 | $72.80 | $1,040.00 | $65.00 – $9,298.64 | 36 |
| Cysto w/ureter stricture tx CPT 52341 | $66.85 | $955.00 | $30.00 – $570.82 | 34 |
| Cytogenomic neo microra alys CPT 81277 | $107.45 | $1,535.00 | $1,160.00 – $4,327.91 | 23 |
| Cytogenom microarray copy nmbr var CPT 81228 | $78.05 | $1,115.00 | $516.91 – $2,858.85 | 22 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $2.59 | $37.00 | $4.23 – $157.75 | 23 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $1.18 | $16.85 | $6.24 – $177.37 | 23 |
| Cyto/molecular report CPT 88291 | $9.66 | $138.00 | $13.62 – $50.49 | 33 |
| Cytopath c/v auto in fluid CPT 88174 | $1.78 | $25.37 | $20.15 – $163.90 | 24 |
| Cytopath c/v index add-on CPT 88155 | $1.03 | $14.65 | $9.35 – $65.88 | 24 |
| Cytopath c/v manual CPT 88150 | $1.30 | $18.54 | $12.67 – $56.85 | 24 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $10.64 | $152.00 | $15.05 – $437.52 | 36 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $2.07 | $29.61 | $25.89 – $222.60 | 24 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $2.48 | $35.38 | $19.83 – $155.46 | 24 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $5.25 | $75.00 | $37.04 – $125.86 | 24 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $10.85 | $155.00 | $68.73 – $231.94 | 24 |
| Cytopath smear oth prep screen & interp CPT 88161 | $5.25 | $75.00 | $29.63 – $101.90 | 24 |
| Cytopath tbs c/v manual CPT 88164 | $2.10 | $30.00 | $12.05 – $56.85 | 24 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $31.29 | $447.00 | $224.71 – $2,572.29 | 24 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $1,635.85 | $23,369.34 | $8.34 – $42.44 | 23 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $84.05 | $1,200.78 | $0.03 – $1,715.91 | 11 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $0.70 | $10.00 | $2.84 – $11.60 | 18 |
| Dark field exam without collj CPT 87166 | $0.73 | $10.42 | $4.13 – $124.14 | 23 |
| D&c after delivery 59160 CPT 59160 | $65.03 | $929.00 | $74.00 – $497.28 | 34 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $72.66 | $1,038.00 | $25.00 – $497.28 | 36 |
| Dch glucoscan CPT 82948 | $6.93 | $99.00 | $1.01 – $31.25 | 36 |
| Dch pulmonary stress test CPT 94621 | $11.48 | $164.00 | $69.55 – $145.74 | 34 |
| Dch validity tests CPT 81002 | $4.48 | $64.00 | $0.49 – $23.52 | 36 |
| Dcmprn plantar digital nerve CPT 64726 | $67.13 | $959.00 | $202.53 – $706.69 | 34 |
| D&c of cervical stump CPT 57558 | $31.29 | $447.00 | $114.97 – $260.48 | 34 |
| Deamidated gliadin antibody iga CPT 86258 | $0.84 | $12.05 | $11.03 – $34.13 | 22 |
| Debr g/per/abd wall 11006 CPT 11006 | $161.00 | $2,300.00 | $426.28 – $1,194.76 | 36 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $72.31 | $1,033.00 | $19.73 – $304.00 | 36 |
| Debridement (>20 cm) charge pt CPT 97598 | $53.76 | $768.00 | $11.36 – $109.89 | 36 |
| Debridement bone <= 20 sq cm CPT 11044 | $553.56 | $7,908.00 | $152.00 – $549.64 | 36 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $178.08 | $2,544.00 | $31.27 – $92.32 | 36 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $365.75 | $5,225.00 | $54.36 – $164.32 | 36 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $222.67 | $3,181.00 | $20.00 – $304.00 | 36 |
| Debride nail1-5 11720 CPT 11720 | $29.82 | $426.00 | $9.00 – $155.62 | 36 |
| Debride nail6 or more 11721 CPT 11721 | $45.43 | $649.00 | $6.70 – $155.62 | 36 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $70.49 | $1,007.00 | $6.00 – $814.99 | 34 |
| Debride skin bone at fx site CPT 11012 | $98.21 | $1,403.00 | $11.00 – $7,662.42 | 36 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | $131.04 | $1,872.00 | $299.00 – $971.40 | 36 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | $176.19 | $2,517.00 | $90.84 – $1,316.16 | 36 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $123.90 | $1,770.00 | $14.52 – $51.44 | 36 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | $29.33 | $419.00 | $42.07 – $304.00 | 36 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $85.33 | $1,219.00 | $6.00 – $1,868.00 | 36 |
| Debr inf skin add-on 11001 CPT 11001 | $6.72 | $96.00 | $10.42 – $35.20 | 36 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $222.67 | $3,181.00 | $11.00 – $408.85 | 36 |
| Decalcification CPT 88311 | $3.50 | $50.00 | $11.33 – $41.24 | 24 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $114.52 | $1,636.00 | $33.51 – $304.00 | 36 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | $111.30 | $1,590.00 | $50.00 – $8,631.30 | 36 |
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.