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 |
|---|---|---|---|---|
| Eeg over 1 hour 95813 - 26 CPT 95813 | $158.06 | $2,258.00 | $131.94 – $649.00 | 23 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $230.16 | $3,288.00 | $58.53 – $1,336.61 | 37 |
| Eeg recording awake and asleep CPT 95819 | $192.15 | $2,745.00 | $58.53 – $569.59 | 37 |
| E equine encephalitis igg CPT 86652 | $0.82 | $11.72 | $4.85 – $145.02 | 23 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $53.55 | $765.00 | $20.00 – $625.53 | 34 |
| Egd control bleeding any CPT 43255 | $218.96 | $3,128.00 | $177.57 – $5,061.94 | 35 |
| Egd dilate stricture CPT 43245 | $218.96 | $3,128.00 | $35.00 – $5,061.94 | 36 |
| Egd endo mucosal resection CPT 43254 | $63.63 | $909.00 | $35.00 – $753.78 | 34 |
| Egd endoscopic stent place CPT 43266 | $4,224.57 | $60,351.00 | $191.80 – $16,014.58 | 36 |
| Egd flx trnsorl rmvl balo CPT 43291 | $34.16 | $488.00 | $35.00 – $748.37 | 33 |
| Egd guide wire insertion CPT 43248 | $39.27 | $561.00 | $15.00 – $673.09 | 34 |
| Egd injection varices CPT 43243 | $218.96 | $3,128.00 | $208.27 – $5,061.94 | 36 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | $33.67 | $481.00 | $35.00 – $389.98 | 34 |
| Egd lesion ablation CPT 43270 | $52.99 | $757.00 | $198.17 – $2,114.78 | 34 |
| Egd optical endomicroscopy CPT 43252 | $39.76 | $568.00 | $20.00 – $599.46 | 34 |
| Egd remove foreign body CPT 43247 | $108.22 | $1,546.00 | $51.01 – $2,392.56 | 36 |
| Egd remove lesion snare CPT 43251 | $121.38 | $1,734.00 | $35.00 – $821.13 | 36 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $40.11 | $573.00 | $20.00 – $747.61 | 34 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | $53.41 | $763.00 | $15.00 – $753.78 | 34 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | $54.88 | $784.00 | $15.00 – $738.08 | 34 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | $61.88 | $884.00 | $20.00 – $1,054.77 | 34 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | $61.88 | $884.00 | $35.00 – $727.61 | 34 |
| Egd varices ligation CPT 43244 | $57.75 | $825.00 | $15.00 – $738.08 | 34 |
| Egd w/transmural drain cyst CPT 43240 | $91.98 | $1,314.00 | $20.00 – $999.81 | 34 |
| Egfr gene com variants CPT 81235 | $12.60 | $180.00 | $82.21 – $649.16 | 23 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $2.11 | $30.15 | $30.15 – $233.26 | 22 |
| EKG (Electrocardiogram) CPT 93000 | $4.48 | $64.00 | $16.02 – $264.90 | 37 |
| EKG for initial prevent exam g0403 HCPCS G0403 | $16.66 | $238.00 | $16.02 – $294.33 | 19 |
| Elbow arthroscopy CPT 29830 | $113.68 | $1,624.00 | $386.82 – $899.33 | 34 |
| Elbow arthroscopy/surgery CPT 29834 | $122.71 | $1,753.00 | $50.00 – $980.01 | 34 |
| Elbow arthroscopy/surgery CPT 29835 | $126.35 | $1,805.00 | $357.04 – $1,003.74 | 34 |
| Elbow arthroscopy/surgery CPT 29836 | $144.97 | $2,071.00 | $80.00 – $1,155.60 | 34 |
| Elbow arthroscopy/surgery CPT 29837 | $128.66 | $1,838.00 | $374.91 – $1,055.94 | 34 |
| Elbow arthroscopy/surgery CPT 29838 | $146.93 | $2,099.00 | $55.00 – $1,181.70 | 34 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | $10.92 | $156.00 | $29.19 – $304.00 | 36 |
| Elect analysis of infusion pump 62367 CPT 62367 | $7.77 | $111.00 | $10.00 – $304.00 | 36 |
| Elect anlys sp inf pmp w/reprg&fill 62369 CPT 62369 | $23.03 | $329.00 | $10.00 – $304.00 | 36 |
| Electrical stimulation/unattended 97014 CPT 97014 | $13.58 | $194.00 | $22.00 – $499.00 | 25 |
| Electric stim/w chemodenervation 95873 CPT 95873 | $12.46 | $178.00 | $20.83 – $164.66 | 37 |
| Electrolyte panel CPT 80051 | $59.01 | $843.00 | $2.49 – $77.14 | 23 |
| Electron microscopy diagnostic CPT 88348 | $49.04 | $700.63 | $328.86 – $2,125.32 | 24 |
| Electrophysiology evaluation CPT 93619 | $62.09 | $887.00 | $368.80 – $771.16 | 34 |
| Electrophysiology evaluation CPT 93641 | $533.96 | $7,628.00 | $294.48 – $852.00 | 34 |
| Electrophysiology evaluation CPT 93642 | $502.81 | $7,183.00 | $653.10 – $3,450.00 | 21 |
| Embedded ip cath exit-site 49436 CPT 49436 | $44.31 | $633.00 | $80.00 – $5,061.94 | 36 |
| Embolization s&i CPT 75894 | $18.90 | $270.00 | $76.64 – $6,795.51 | 31 |
| Embo or occlude vascular arterial s&i CPT 37242 | $3,175.48 | $45,364.00 | $400.29 – $48,357.40 | 36 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $3,201.10 | $45,730.00 | $80.00 – $30,452.80 | 36 |
| Embo or occlude vascular tumor/organ/infarct s&i CPT 37243 | $2,696.26 | $38,518.00 | $474.08 – $30,452.80 | 36 |
| Embo or occlude vascular venous s&i CPT 37241 | $2,560.88 | $36,584.00 | $4,381.60 – $30,452.80 | 18 |
| Emb/throm/fempop/aor/ilia/leg inc 34201 CPT 34201 | $227.08 | $3,244.00 | $65.00 – $14,678.70 | 36 |
| Emb/throm/pop-tib-pero art/leg inc 34203 CPT 34203 | $211.68 | $3,024.00 | $118.02 – $14,678.70 | 36 |
| Emb w/colposcopy 58110 CPT 58110 | $11.97 | $171.00 | $34.21 – $107.88 | 36 |
| Emb without cervical dilation 58100 CPT 58100 | $24.50 | $350.00 | $41.04 – $304.00 | 36 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $27.72 | $396.00 | $80.35 – $350.97 | 37 |
| Emg 3 ext w-w/o paraspinal area 95863 CPT 95863 | $37.80 | $540.00 | $97.76 – $339.43 | 37 |
| Emg cranial nerve bilateral CPT 95868 | $22.54 | $322.00 | $63.75 – $569.59 | 37 |
| Emg needle test 1-extremity CPT 95860 | $19.88 | $284.00 | $53.15 – $350.97 | 37 |
| Emg needle test 4-extremities CPT 95864 | $39.90 | $570.00 | $108.33 – $629.13 | 37 |
| Emg thor paraspinal without t1/t2 CPT 95869 | $16.59 | $237.00 | $20.27 – $569.59 | 37 |
| Encephalitis, california igg/igm CPT 86651 | $0.82 | $11.72 | $4.85 – $145.02 | 23 |
| Encephalitis, st louis igg/igm CPT 86653 | $0.82 | $11.72 | $4.85 – $145.02 | 23 |
| Encephalitis, western equine igg/igm CPT 86654 | $0.82 | $11.72 | $4.85 – $145.02 | 23 |
| Endo abl/incom vein/ext/laser/#1 36478 CPT 36478 | $63.00 | $900.00 | $236.50 – $8,329.20 | 36 |
| Endo abl/incom vein/ext/rad fre/#1 36475 CPT 36475 | $1,827.56 | $26,108.00 | $152.00 – $3,562.10 | 36 |
| Endo cath bile duct s&i CPT 74328 | $238.70 | $3,410.00 | $24.77 – $886.90 | 35 |
| Endo cath panc duct s&i CPT 74329 | $8.61 | $123.00 | $25.14 – $147.60 | 34 |
| Endocerv curettage w/scope 57456 CPT 57456 | $37.03 | $529.00 | $60.00 – $304.00 | 36 |
| Endocervical curettage 57505 CPT 57505 | $38.15 | $545.00 | $30.00 – $304.00 | 36 |
| Endo cholangiopancreatograph CPT 43261 | $79.45 | $1,135.00 | $20.00 – $910.82 | 34 |
| Endo cholangiopancreatograph CPT 43262 | $83.86 | $1,198.00 | $20.00 – $1,070.48 | 34 |
| Endoluminal bx urtr rnl plvs CPT 50606 | $329.28 | $4,704.00 | $122.40 – $759.41 | 18 |
| Endoluminl ivus oct c 1st CPT 92978 | $874.44 | $12,492.00 | $90.39 – $268.80 | 34 |
| Endoluminl ivus oct c ea CPT 92979 | $12.39 | $177.00 | $71.79 – $212.40 | 34 |
| Endome abla/them without hystero guide 58353 CPT 58353 | $224.00 | $3,200.00 | $55.00 – $2,854.74 | 36 |
| Endometrial cryoablation w/us 58356 CPT 58356 | $83.02 | $1,186.00 | $297.89 – $13,196.08 | 36 |
| Endoscopic injection/implant CPT 51715 | $86.66 | $1,238.00 | $152.00 – $510.32 | 36 |
| Endoscopic pancreatoscopy CPT 43273 | $27.86 | $398.00 | $20.00 – $214.25 | 34 |
| Endoscopic Ultrasound exam esoph CPT 43237 | $1,376.27 | $19,661.00 | $125.09 – $5,061.94 | 36 |
| Endoscopic vein harvest 33508 CPT 33508 | $3.43 | $49.00 | $12.66 – $29.74 | 34 |
| Endoscopy bowel pouch/biop CPT 44386 | $21.28 | $304.00 | $45.00 – $577.53 | 34 |
| Endoscopy maxillary sinus CPT 31267 | $94.36 | $1,348.00 | $60.00 – $18,617.04 | 36 |
| Endoscopy of bowel pouch 44385 CPT 44385 | $17.36 | $248.00 | $15.00 – $432.11 | 34 |
| Endoscopy swallow (fees) vid CPT 92612 | $11.55 | $165.00 | $55.10 – $280.13 | 36 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | $63.56 | $908.00 | $143.80 – $441.06 | 36 |
| Endovasc rpr a-biiliac endogft 34705 CPT 34705 | $338.17 | $4,831.00 | $65.00 – $3,701.66 | 36 |
| Endovenous laser vein addon 36479 CPT 36479 | $30.59 | $437.00 | $10.00 – $727.52 | 36 |
| Endovenous rf abl vein addl CPT 36476 | $1,033.13 | $14,759.00 | $111.39 – $713.79 | 36 |
| Endoven ther chem adhes 1st 36482 CPT 36482 | $40.53 | $579.00 | $20.00 – $14,678.70 | 36 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $39.79 | $568.38 | $0.53 – $8.05 | 19 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | $0.84 | $11.98 | $2.78 – $102.08 | 23 |
| Enterectomy small intestine addl 44121 CPT 44121 | $54.95 | $785.00 | $40.00 – $448.10 | 34 |
| Enterectomy small intestine single 44120 CPT 44120 | $284.55 | $4,065.00 | $35.00 – $2,192.86 | 36 |
| Enteroenterostomy fusion 44130 CPT 44130 | $307.79 | $4,397.00 | $602.75 – $2,121.96 | 34 |
| Enterorrhaphy 1perforation 44602 CPT 44602 | $325.01 | $4,643.00 | $40.00 – $2,328.22 | 34 |
| Enterorrhaphy multiple perforations 44603 CPT 44603 | $375.20 | $5,360.00 | $65.00 – $2,859.60 | 36 |
| Enterostomy/cecostomy tube open 44300 CPT 44300 | $197.40 | $2,820.00 | $20.00 – $5,061.94 | 36 |
| Envrn ivntj med mgmt psyc pt CPT 90882 | $10.15 | $145.00 | $74.00 – $174.00 | 15 |
| Enzyme cell activity ra CPT 82658 | $32.75 | $467.92 | $6.71 – $197.73 | 23 |
| Enzyme histochemistry CPT 88319 | $5.72 | $81.75 | $70.95 – $2,125.32 | 24 |
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.