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 |
|---|---|---|---|---|
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $3.57 | $51.00 | $12.13 – $52.80 | 33 |
| Adrenal cortex & medulla img CPT 78075 | $9.66 | $138.00 | $34.69 – $563.81 | 34 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $12.46 | $178.00 | $62.64 – $206.85 | 36 |
| _afb id by dna probe rflx ast CPT 87149 | $17.50 | $250.00 | $4.48 – $220.30 | 23 |
| #afb mycobacteria suscep. #1 CPT 87190 | $0.51 | $7.31 | $1.25 – $59.37 | 23 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $7.18 | $102.54 | $28.24 – $1,072.65 | 23 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | $152.60 | $2,180.00 | $326.23 – $2,528.80 | 34 |
| After cataract laser surgery CPT 66821 | $76.86 | $1,098.00 | $30.00 – $1,450.85 | 36 |
| Air conduction bilat CPT 92552 | $14.91 | $213.00 | $11.08 – $350.97 | 36 |
| Air injection into abdomen 49400 CPT 49400 | $21.07 | $301.00 | $30.00 – $268.74 | 34 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $2.17 | $31.00 | $12.70 – $44.15 | 34 |
| Albumin body fluid quantitative each specimen CPT 82042 | $40.74 | $582.00 | $0.78 – $56.85 | 23 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $227.59 | $3,251.23 | $45.34 – $144.51 | 23 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $101.64 | $1,452.00 | $46.65 – $144.51 | 23 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $27.86 | $398.00 | $2.20 – $63.66 | 23 |
| Albumin serum plasma or whole blood CPT 82040 | $41.02 | $586.00 | $1.46 – $54.48 | 23 |
| Albuterol ipratrop non-comp HCPCS J7620 | $3.08 | $44.00 | $0.20 – $6.00 | 19 |
| Albuterol non-comp con HCPCS J7611 | $4.69 | $67.00 | $0.07 – $32.40 | 19 |
| Albuterol non-comp unit HCPCS J7613 | $2.03 | $29.00 | $0.07 – $12.76 | 19 |
| Alginate dressing <=16 sq in HCPCS A6196 | $1.82 | $26.00 | $3.34 – $31.20 | 32 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | $3.99 | $57.00 | $7.46 – $68.40 | 32 |
| Alginate drsg wound filler HCPCS A6199 | $1.26 | $18.00 | $2.40 – $21.60 | 32 |
| Alkaline phosphatase CPT 84075 | $43.33 | $619.00 | $1.79 – $56.85 | 23 |
| Allergen alpha lactalbumin ige CPT 86008 | $2.82 | $40.25 | $5.00 – $174.19 | 23 |
| Allergen egg white ige CPT 86003 | $2.38 | $34.03 | $1.82 – $173.82 | 23 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $0.56 | $7.97 | $7.97 – $178.11 | 22 |
| Allergy injections; 2 or more 95117 CPT 95117 | $4.34 | $62.00 | $9.45 – $123.52 | 36 |
| Allergy injection; single 95115 CPT 95115 | $4.34 | $62.00 | $4.90 – $123.52 | 36 |
| Allergy Skin Testing CPT 95004 | $0.84 | $12.00 | $1.90 – $304.00 | 37 |
| Allg patch or app # of tests 95044 CPT 95044 | $1.05 | $15.00 | $3.70 – $13.24 | 34 |
| Allgrft implnt knee w/scope CPT 29867 | $309.96 | $4,428.00 | $90.00 – $2,541.38 | 34 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $97.23 | $1,389.00 | $127.26 – $459.36 | 35 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $11.83 | $169.00 | $47.19 – $346.14 | 22 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $89.25 | $1,275.00 | $139.47 – $1,821.98 | 20 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $97.23 | $1,389.00 | $127.26 – $704.12 | 33 |
| All tstg perq&iq drugs/biol CPT 95018 | $3.78 | $54.00 | $6.03 – $175.35 | 37 |
| All tstg perq&iq w/venoms CPT 95017 | $1.54 | $22.00 | $2.92 – $140.16 | 37 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $0.40 | $5.65 | $1.31 – $14.62 | 23 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $4.01 | $57.26 | $15.77 – $692.82 | 23 |
| Alpha-fetoprotein amniotic CPT 82106 | $0.84 | $12.03 | $12.03 – $184.48 | 22 |
| Alpha-fetoprotein tumor marker CPT 82105 | $19.39 | $277.00 | $12.03 – $184.48 | 23 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $4,047.29 | $57,818.41 | $17.52 – $255.45 | 23 |
| Alt/sgpt CPT 84460 | $45.64 | $652.00 | $1.68 – $57.52 | 23 |
| Aluminum - quest CPT 82108 | $1.78 | $25.48 | $9.53 – $280.19 | 23 |
| Alveoloplasty each quadrant CPT 41874 | $62.09 | $887.00 | $55.00 – $514.96 | 34 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $13.79 | $197.00 | $35.02 – $529.79 | 37 |
| Amantadine (symmetrel)-sendout CPT 80375 | $17.92 | $256.00 | $0.03 – $181.96 | 8 |
| Ambl bp mntr w/software CPT 93784 | $10.08 | $144.00 | $48.40 – $134.42 | 34 |
| Amino acids quant 2-5 CPT 82136 | $1.10 | $15.69 | $6.25 – $184.62 | 23 |
| Aminolevulinic acid delta CPT 82135 | $1.15 | $16.45 | $6.09 – $181.00 | 23 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $101.27 | $1,446.76 | $2.14 – $1,239.80 | 10 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $5.05 | $72.10 | $0.92 – $103.04 | 10 |
| Amitriptyline (elavil) -sendout CPT 80335 | $2.43 | $34.77 | $0.03 – $180.77 | 8 |
| Ammonia CPT 82140 | $64.12 | $916.00 | $4.19 – $160.27 | 23 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $18.48 | $264.00 | $57.26 – $281.53 | 34 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $170.73 | $2,439.00 | $310.87 – $1,362.04 | 34 |
| Amphetamine confirm urine -sendout CPT 80324 | $16.03 | $229.00 | $0.03 – $156.94 | 8 |
| Amphetamines 5 or more CPT 80326 | $17.08 | $244.00 | $0.03 – $188.32 | 8 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $24.37 | $348.18 | $1.33 – $228.64 | 11 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $23.53 | $336.16 | $2.99 – $354.99 | 10 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $100.45 | $1,435.00 | $262.99 – $620.91 | 22 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $761.11 | $10,873.00 | $40.00 – $8,631.30 | 36 |
| Amp thigh through femur re-amp 27596 CPT 27596 | $167.30 | $2,390.00 | $141.47 – $1,456.96 | 34 |
| Amputate leg at thigh CPT 27592 | $158.13 | $2,259.00 | $125.00 – $8,631.30 | 36 |
| Amputate lower leg at knee CPT 27598 | $163.66 | $2,338.00 | $115.00 – $1,475.94 | 34 |
| Amputate metacarpal bone 26910 CPT 26910 | $189.28 | $2,704.00 | $27.00 – $1,456.96 | 34 |
| Amputate thigh through femur 27590 CPT 27590 | $180.95 | $2,585.00 | $304.00 – $8,631.30 | 36 |
| Amputation follow-up surgery CPT 25931 | $197.26 | $2,818.00 | $25.00 – $1,494.93 | 34 |
| Amputation follow-up surgery CPT 27594 | $121.24 | $1,732.00 | $65.00 – $8,631.30 | 36 |
| Amputation follow-up surgery CPT 27884 | $137.48 | $1,964.00 | $116.90 – $8,631.30 | 36 |
| Amputation leg thr tib/fib 27880 CPT 27880 | $208.11 | $2,973.00 | $101.27 – $1,812.90 | 34 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | $153.30 | $2,190.00 | $124.35 – $1,326.45 | 34 |
| Amputation of foot at ankle CPT 27889 | $150.29 | $2,147.00 | $60.00 – $1,385.77 | 34 |
| Amputation of foot at ankle CPT 27888 | $131.60 | $1,880.00 | $105.00 – $1,426.11 | 34 |
| Amputation of hand CPT 25927 | $212.80 | $3,040.00 | $84.51 – $1,594.59 | 34 |
| Amputation of lower leg CPT 27882 | $137.76 | $1,968.00 | $120.00 – $8,631.30 | 36 |
| Amputation of lower leg CPT 27881 | $194.39 | $2,777.00 | $65.00 – $1,793.91 | 34 |
| Amputation of midtarsal 28800 CPT 28800 | $128.87 | $1,841.00 | $421.82 – $1,110.38 | 34 |
| Amputation of upper arm CPT 24900 | $187.81 | $2,683.00 | $120.00 – $1,392.89 | 34 |
| Amputation thru metatarsal CPT 28805 | $169.89 | $2,427.00 | $421.82 – $1,401.45 | 34 |
| Amputation toe interphalangeal joint CPT 28825 | $71.12 | $1,016.00 | $45.00 – $808.53 | 36 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $72.52 | $1,036.00 | $152.00 – $943.29 | 36 |
| Amylase CPT 82150 | $57.96 | $828.00 | $2.30 – $71.36 | 23 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $4.34 | $62.00 | $0.03 – $204.39 | 8 |
| Anal/urinary muscle study CPT 51784 | $18.83 | $269.00 | $35.00 – $304.00 | 36 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | $9.94 | $142.00 | $42.49 – $120.43 | 34 |
| Analysis gene f2 20210g>a variant CPT 81240 | $4.60 | $65.69 | $37.90 – $333.12 | 22 |
| Analysis gene f5 leiden variant CPT 81241 | $5.14 | $73.37 | $37.99 – $424.17 | 22 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $7.49 | $107.00 | $50.23 – $344.60 | 20 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $8.33 | $119.00 | $33.72 – $283.55 | 37 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $2.11 | $30.15 | $30.15 – $233.26 | 22 |
| Anca screen with reflex to titer -quest CPT 86021 | $1.05 | $15.05 | $5.14 – $165.52 | 23 |
| An cholangiogram percutaneous compl CPT 47531 | $407.40 | $5,820.00 | $8.00 – $9,444.82 | 36 |
| Androstanediol CPT 82154 | $20.14 | $287.75 | $10.80 – $316.61 | 23 |
| An fluoro guide for cvp CPT 77001 | $160.37 | $2,291.00 | $17.68 – $375.89 | 36 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $1,575.42 | $22,506.00 | $45.00 – $1,999.54 | 36 |
| Angiotensin ii CPT 82163 | $8.33 | $119.00 | $6.72 – $218.38 | 23 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $915.20 | $13,074.30 | $2.94 – $74.00 | 11 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $39.27 | $561.00 | $45.00 – $2,585.21 | 34 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $1,201.20 | $17,160.00 | $50.00 – $15,013.92 | 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.