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 |
|---|---|---|---|---|
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $168.98 | $2,414.00 | $124.72 – $5,442.78 | 36 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $27.44 | $392.00 | $7.00 – $205.46 | 36 |
| Epidural lysis on single day 62264 CPT 62264 | $58.94 | $842.00 | $23.00 – $705.99 | 34 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $20.63 | $294.71 | $0.94 – $421.14 | 10 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $24.41 | $348.75 | $1.02 – $498.37 | 10 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $2.24 | $32.00 | $0.33 – $24.28 | 14 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $15.24 | $217.72 | $1.02 – $311.12 | 10 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $33.88 | $484.00 | $53.00 – $405.19 | 34 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $1.54 | $22.00 | $6.24 – $22.00 | 23 |
| Epstein barr early antigen antibody CPT 86663 | $0.92 | $13.12 | $4.82 – $145.02 | 23 |
| Epstein barr nuclear antigen antibody CPT 86664 | $1.07 | $15.29 | $5.65 – $170.71 | 23 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $1.27 | $18.14 | $6.50 – $177.29 | 23 |
| Ercp biliary & pancreas CPT 74330 | $332.92 | $4,756.00 | $28.37 – $886.90 | 35 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $108.43 | $1,549.00 | $20.00 – $1,290.33 | 34 |
| Ercp ea duct/ampulla dilate CPT 43277 | $88.83 | $1,269.00 | $20.00 – $1,070.48 | 34 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | $101.50 | $1,450.00 | $50.00 – $1,217.04 | 34 |
| Ercp lithotripsy calculi CPT 43265 | $101.43 | $1,449.00 | $50.00 – $1,442.13 | 34 |
| Ercp remove duct calculi 43264 CPT 43264 | $85.54 | $1,222.00 | $55.00 – $1,285.09 | 34 |
| Ercp remove forgn body duct 43275 CPT 43275 | $88.34 | $1,262.00 | $20.00 – $1,065.24 | 34 |
| Ercp sphincter pressure meas CPT 43263 | $84.00 | $1,200.00 | $25.00 – $1,060.01 | 34 |
| Ercp stent exchange w/dilate CPT 43276 | $112.84 | $1,612.00 | $20.00 – $1,342.67 | 34 |
| Ercp w/specimen collection CPT 43260 | $75.81 | $1,083.00 | $281.23 – $866.33 | 27 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $72.66 | $1,038.03 | $9.16 – $100.92 | 19 |
| ER Visit (level 1, minor) CPT 99281 | $78.82 | $1,126.00 | $10.34 – $222.44 | 36 |
| ER Visit (level 2) CPT 99282 | $152.04 | $2,172.00 | $24.38 – $304.00 | 36 |
| ER Visit (level 3) CPT 99283 | $263.55 | $3,765.00 | $44.60 – $304.00 | 36 |
| ER Visit (level 4) CPT 99284 | $439.95 | $6,285.00 | $68.35 – $304.00 | 36 |
| ER Visit (level 5, high severity) CPT 99285 | $625.73 | $8,939.00 | $108.08 – $306.69 | 36 |
| Escharotomy ea addl incision CPT 16036 | $19.04 | $272.00 | $40.00 – $135.38 | 34 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $201.89 | $2,884.15 | $0.33 – $350.22 | 10 |
| Esophageal dilat s&i CPT 74360 | $7.35 | $105.00 | $29.51 – $886.83 | 35 |
| Esophageal motility CPT 78258 | $9.10 | $130.00 | $34.33 – $276.65 | 34 |
| Esophagosc dilate balloon 30 CPT 43214 | $45.99 | $657.00 | $166.39 – $528.69 | 34 |
| Esophagoscop stent placement CPT 43212 | $44.17 | $631.00 | $165.30 – $512.99 | 34 |
| Esophagoscop ultrasound exam CPT 43231 | $36.96 | $528.00 | $15.00 – $659.49 | 34 |
| Esophagoscopy balloon <30mm CPT 43220 | $28.14 | $402.00 | $15.00 – $1,887.64 | 34 |
| Esophagoscopy control bleed CPT 43227 | $39.06 | $558.00 | $40.00 – $643.44 | 34 |
| Esophagoscopy flex biopsy CPT 43202 | $24.50 | $350.00 | $40.00 – $596.45 | 34 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $20.93 | $299.00 | $35.00 – $2,392.56 | 36 |
| Esophagoscopy flex dx brush CPT 43197 | $19.32 | $276.00 | $40.00 – $531.31 | 34 |
| Esophagoscopy flex remove fb CPT 43215 | $33.39 | $477.00 | $20.00 – $668.89 | 34 |
| Esophagoscopy lesion ablate CPT 43229 | $46.34 | $662.00 | $174.82 – $2,135.72 | 34 |
| Esophagoscopy retro balloon CPT 43213 | $60.83 | $869.00 | $20.00 – $3,658.99 | 34 |
| Esophagoscopy rigid balloon CPT 43195 | $44.52 | $636.00 | $35.00 – $489.44 | 34 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | $37.52 | $536.00 | $15.00 – $5,061.94 | 36 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | $132.02 | $1,886.00 | $477.23 – $1,538.97 | 34 |
| Esophagoscopy snare les remv CPT 43217 | $37.94 | $542.00 | $15.00 – $731.03 | 34 |
| Esophagoscopy w/us needle bx CPT 43232 | $46.83 | $669.00 | $40.00 – $783.07 | 34 |
| Esophagoscp rig trnso biopsy CPT 43193 | $40.81 | $583.00 | $147.32 – $489.44 | 34 |
| Esophagoscp rig trnso rem fb CPT 43194 | $45.71 | $653.00 | $20.00 – $437.09 | 34 |
| Esophagus motility study CPT 91010 | $414.33 | $5,919.00 | $69.11 – $984.36 | 37 |
| Esoph egd dilation <30 mm CPT 43249 | $218.96 | $3,128.00 | $35.00 – $5,061.94 | 36 |
| Esoph endoscopy dilation CPT 43226 | $30.87 | $441.00 | $116.01 – $622.88 | 34 |
| Esophgl motil w/stim/perfus CPT 91013 | $114.94 | $1,642.00 | $28.56 – $106.23 | 20 |
| Esoph imped function test CPT 91037 | $191.10 | $2,730.00 | $144.16 – $1,048.30 | 20 |
| Esoph imped funct test > 1hr CPT 91038 | $292.18 | $4,174.00 | $111.30 – $984.36 | 20 |
| Esoph scope w/submucous inj CPT 43201 | $24.71 | $353.00 | $20.00 – $451.55 | 34 |
| Essure 58565 CPT 58565 | $599.20 | $8,560.00 | $152.00 – $4,228.18 | 36 |
| Establish access to aorta CPT 36160 | $367.29 | $5,247.00 | $103.92 – $220.61 | 18 |
| Establish access to artery CPT 36100 | $1,624.28 | $23,204.00 | $125.94 – $367.67 | 18 |
| Established Patient Office Visit (level 1) CPT 99211 | $102.41 | $1,463.00 | $7.76 – $46.11 | 35 |
| Established Patient Office Visit (level 2) CPT 99212 | $35.63 | $509.00 | $18.10 – $72.42 | 35 |
| Established Patient Office Visit (level 3) CPT 99213 | $38.85 | $555.00 | $24.00 – $115.70 | 35 |
| Established Patient Office Visit (level 4) CPT 99214 | $49.35 | $705.00 | $37.50 – $169.86 | 35 |
| Established Patient Office Visit (level 5) CPT 99215 | $61.39 | $877.00 | $57.20 – $252.66 | 35 |
| Estradiol total CPT 82670 | $25.62 | $366.00 | $10.47 – $307.29 | 23 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $2.38 | $34.00 | $5.33 – $33.60 | 19 |
| Estrogens total-sendout CPT 82672 | $1.52 | $21.70 | $8.08 – $238.52 | 23 |
| Ethylene glycol -sendout CPT 82693 | $1.04 | $14.90 | $5.49 – $161.75 | 23 |
| Etonogestrel implant system HCPCS J7307 | $163.66 | $2,338.00 | $1,221.01 – $2,805.60 | 18 |
| Euflexxa inj per dose HCPCS J7323 | $26.32 | $376.00 | $92.67 – $383.96 | 18 |
| Evacuate mole of uterus CPT 59870 | $127.75 | $1,825.00 | $70.00 – $960.35 | 34 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $40.67 | $581.00 | $98.11 – $537.66 | 22 |
| Evaluation heart device CPT 93640 | $42.14 | $602.00 | $168.91 – $722.40 | 34 |
| Evaluation of speech fluency 92521 CPT 92521 | $89.53 | $1,279.00 | $103.25 – $499.00 | 25 |
| Evaluation psychiatric diagnostic CPT 90791 | $29.89 | $427.00 | $139.95 – $468.22 | 36 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $304.15 | $4,345.00 | $1,154.87 – $3,347.05 | 34 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $258.58 | $3,694.00 | $35.00 – $2,781.96 | 34 |
| Event monitor CPT 93270 | $6.65 | $95.00 | $8.96 – $419.73 | 36 |
| Evoked auditory tst complete CPT 92588 | $6.79 | $97.00 | $29.84 – $73.48 | 34 |
| Evoked oa emissions ltd CPT 92587 | $41.93 | $599.00 | $11.23 – $569.59 | 36 |
| Evoked potentials auditory screening automated analysis CPT 92650 | $22.61 | $323.00 | $35.36 – $461.57 | 9 |
| Evok oa screening qual CPT 92558 | $22.61 | $323.00 | $323.00 – $461.57 | 8 |
| Exam of vagina w/scope 57420 CPT 57420 | $32.62 | $466.00 | $25.00 – $304.00 | 36 |
| Exam pelvic add-on CPT 99459 | $3.99 | $57.00 | $19.04 – $74.00 | 35 |
| Exam plvc w/anes othr thn lcl CPT 57410 | $25.34 | $362.00 | $25.00 – $221.01 | 34 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | $330.40 | $4,720.00 | $60.00 – $7,662.42 | 36 |
| Ex arm/elbow tum deep 5 cm/> CPT 24073 | $330.40 | $4,720.00 | $28.00 – $7,662.42 | 36 |
| Exc abd les sc 3 cm/> CPT 22903 | $330.40 | $4,720.00 | $63.00 – $1,055.94 | 36 |
| Exc abdl tum deep < 5 cm CPT 22900 | $330.40 | $4,720.00 | $65.00 – $7,662.42 | 36 |
| Exc abdl tum deep 5 cm/> CPT 22901 | $159.46 | $2,278.00 | $68.00 – $7,662.42 | 36 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | $330.40 | $4,720.00 | $22.00 – $975.26 | 36 |
| Exc arm/elbo les sc <3cm 24075 CPT 24075 | $187.04 | $2,672.00 | $67.39 – $889.84 | 36 |
| Exc back les sbq <3 cm 21930 CPT 21930 | $187.04 | $2,672.00 | $25.00 – $868.48 | 36 |
| Exc back tum deep 5 cm/> CPT 21933 | $330.40 | $4,720.00 | $152.00 – $1,767.81 | 36 |
| Exc bartholins gland/cyst CPT 56740 | $75.53 | $1,079.00 | $55.00 – $618.31 | 36 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $70.21 | $1,003.00 | $21.00 – $414.26 | 36 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | $94.92 | $1,356.00 | $16.00 – $555.06 | 36 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $187.04 | $2,672.00 | $101.27 – $333.03 | 36 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $68.25 | $975.00 | $14.00 – $304.00 | 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.