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 |
|---|---|---|---|---|
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $66.50 | $950.00 | $16.00 – $304.00 | 36 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $81.20 | $1,160.00 | $41.00 – $304.00 | 36 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $157.50 | $2,250.00 | $99.03 – $327.62 | 36 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $81.20 | $1,160.00 | $19.00 – $304.00 | 36 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $166.25 | $2,375.00 | $19.00 – $304.00 | 36 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $271.25 | $3,875.00 | $34.00 – $481.95 | 36 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $46.13 | $659.00 | $14.00 – $304.00 | 36 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $94.50 | $1,350.00 | $14.00 – $304.00 | 36 |
| Exc breast duct fistula 19112 CPT 19112 | $79.38 | $1,134.00 | $334.10 – $576.50 | 34 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | $269.01 | $3,843.00 | $65.00 – $2,536.63 | 34 |
| Exc coccygl pr ulc flap clsr CPT 15922 | $195.44 | $2,792.00 | $115.04 – $1,134.48 | 34 |
| Exc coccygl pr ulc prim sutr CPT 15920 | $153.44 | $2,192.00 | $50.63 – $913.34 | 34 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | $374.57 | $5,351.00 | $337.30 – $8,631.30 | 36 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | $146.72 | $2,096.00 | $80.04 – $1,143.74 | 34 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | $116.83 | $1,669.00 | $37.00 – $686.26 | 36 |
| Exc face tum deep < 2 cm CPT 21013 | $131.88 | $1,884.00 | $152.00 – $1,224.42 | 36 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | $330.40 | $4,720.00 | $85.00 – $1,264.76 | 36 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $81.20 | $1,160.00 | $137.07 – $327.62 | 36 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $187.04 | $2,672.00 | $152.00 – $454.88 | 36 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | $110.74 | $1,582.00 | $74.46 – $7,662.42 | 36 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | $94.64 | $1,352.00 | $30.00 – $584.84 | 36 |
| Exc forearm les sc 3 cm/> CPT 25071 | $103.74 | $1,482.00 | $70.36 – $1,025.09 | 36 |
| Exc forearm tum deep < 3 cm CPT 25076 | $128.94 | $1,842.00 | $60.00 – $4,356.78 | 36 |
| Exc forearm tum deep 3 cm/> CPT 25073 | $132.30 | $1,890.00 | $152.00 – $1,283.74 | 36 |
| Exc hand les sc < 1.5 cm CPT 26115 | $187.04 | $2,672.00 | $60.00 – $1,264.76 | 36 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | $187.04 | $2,672.00 | $90.47 – $1,324.08 | 36 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | $131.18 | $1,874.00 | $411.73 – $4,356.78 | 35 |
| Exchange biliary drg cath CPT 47536 | $1,111.60 | $15,880.00 | $10.00 – $9,444.82 | 36 |
| Exchange drainage catheter CPT 49423 | $490.00 | $7,000.00 | $17.00 – $5,061.94 | 36 |
| Exchange lens prosthesis CPT 66986 | $219.80 | $3,140.00 | $140.00 – $1,664.35 | 34 |
| Exchange nephrostomy cath CPT 50435 | $527.38 | $7,534.00 | $87.87 – $5,514.28 | 36 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | $280.00 | $4,000.00 | $36.00 – $7,662.42 | 36 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | $85.68 | $1,224.00 | $20.00 – $7,662.42 | 36 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | $112.35 | $1,605.00 | $16.00 – $557.77 | 36 |
| Exc hip/pelv tum deep < 5 cm CPT 27048 | $148.82 | $2,126.00 | $70.00 – $7,662.42 | 36 |
| Exc hip/pelv tum deep 5 cm/> CPT 27045 | $176.54 | $2,522.00 | $611.69 – $7,662.42 | 36 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | $330.40 | $4,720.00 | $152.00 – $1,611.20 | 36 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | $86.59 | $1,237.00 | $65.00 – $7,662.42 | 36 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | $168.42 | $2,406.00 | $568.50 – $7,662.42 | 36 |
| Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 CPT 15946 | $384.09 | $5,487.00 | $40.00 – $2,485.58 | 34 |
| Exc ischial pr ulc prim sutr CPT 15940 | $171.22 | $2,446.00 | $98.66 – $1,055.96 | 34 |
| Excise anal ext tag/papilla CPT 46220 | $136.08 | $1,944.00 | $49.89 – $304.00 | 36 |
| Excise foot tendon sheath CPT 28086 | $86.24 | $1,232.00 | $50.00 – $972.93 | 34 |
| Excise ileoanal reservior CPT 45136 | $423.50 | $6,050.00 | $256.14 – $3,187.30 | 34 |
| Excise inferior turbinate CPT 30130 | $104.16 | $1,488.00 | $24.00 – $8,745.94 | 36 |
| Excise intestine lesion(s) 44110 CPT 44110 | $200.27 | $2,861.00 | $70.00 – $1,556.42 | 36 |
| Excise intraspinl lesion crv CPT 63265 | $388.50 | $5,550.00 | $1,356.66 – $3,950.67 | 34 |
| Excise intrspinl lesion lmbr CPT 63267 | $323.19 | $4,617.00 | $40.00 – $3,275.27 | 34 |
| Excise intrspinl lesion lmbr CPT 63272 | $70.35 | $1,005.00 | $70.00 – $4,532.18 | 34 |
| Excise lesion testis CPT 54512 | $130.20 | $1,860.00 | $35.00 – $915.41 | 34 |
| Excise lip or cheek fold CPT 40819 | $68.46 | $978.00 | $152.00 – $475.34 | 36 |
| Excise mandible lesion CPT 21040 | $90.65 | $1,295.00 | $37.23 – $901.70 | 34 |
| Excise max/zygoma b9 tumor CPT 21030 | $90.30 | $1,290.00 | $345.33 – $896.96 | 27 |
| Excise parotid gland/lesion CPT 42410 | $152.95 | $2,185.00 | $65.00 – $15,616.06 | 36 |
| Excise parotid gland/lesion CPT 42415 | $255.64 | $3,652.00 | $584.00 – $15,616.06 | 36 |
| Excise parotid gland/lesion CPT 42420 | $285.74 | $4,082.00 | $60.00 – $15,616.06 | 36 |
| Excise parotid gland/lesion CPT 42425 | $203.35 | $2,905.00 | $70.00 – $1,555.31 | 34 |
| Excise pharynx lesion CPT 42808 | $40.95 | $585.00 | $35.00 – $8,745.94 | 36 |
| Excise/repair mouth lesion CPT 40812 | $69.16 | $988.00 | $50.00 – $404.50 | 36 |
| Excise sublingual gland CPT 42450 | $90.30 | $1,290.00 | $35.00 – $15,616.06 | 36 |
| Excise submaxillary gland CPT 42440 | $101.85 | $1,455.00 | $60.00 – $15,616.06 | 36 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | $187.04 | $2,672.00 | $60.00 – $1,055.94 | 36 |
| Excise tendon forearm/wrist CPT 25109 | $134.05 | $1,915.00 | $40.00 – $987.13 | 34 |
| Excise wrist tendon sheath CPT 25118 | $97.02 | $1,386.00 | $372.30 – $4,241.76 | 36 |
| Excision addl breast lesion 19126 CPT 19126 | $36.54 | $522.00 | $50.00 – $338.58 | 34 |
| Excision aural polyp CPT 69540 | $32.34 | $462.00 | $52.12 – $4,092.96 | 36 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $75.95 | $1,085.00 | $16.00 – $304.00 | 36 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $157.50 | $2,250.00 | $74.09 – $304.00 | 36 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $81.20 | $1,160.00 | $71.85 – $304.00 | 36 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $171.50 | $2,450.00 | $19.00 – $419.68 | 36 |
| Excision breast lesion CPT 19125 | $110.88 | $1,584.00 | $240.51 – $853.31 | 34 |
| Excision floor mouth lesion 41116 CPT 41116 | $53.97 | $771.00 | $178.70 – $8,745.94 | 36 |
| Excision graft extremity CPT 35903 | $127.96 | $1,828.00 | $99.03 – $8,329.20 | 36 |
| Excision hand/finger tendon CPT 26415 | $210.14 | $3,002.00 | $141.85 – $1,499.67 | 34 |
| Excision lesion mouth roof CPT 42106 | $63.21 | $903.00 | $50.00 – $343.41 | 36 |
| Excision lesion mouth roof CPT 42107 | $80.64 | $1,152.00 | $50.00 – $15,616.06 | 36 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | $62.02 | $886.00 | $12.00 – $311.04 | 36 |
| Excision of anal lesion(s) CPT 46922 | $322.98 | $4,614.00 | $40.00 – $330.11 | 36 |
| Excision of gum lesion 41825 CPT 41825 | $30.52 | $436.00 | $45.00 – $8,745.94 | 36 |
| Excision of lesion of mesentery 44820 CPT 44820 | $200.06 | $2,858.00 | $110.95 – $1,441.51 | 34 |
| Excision of lingual tonsil CPT 42870 | $146.51 | $2,093.00 | $35.00 – $995.78 | 34 |
| Excision of meckels diverticulum 44800 CPT 44800 | $183.75 | $2,625.00 | $35.00 – $1,308.74 | 34 |
| Excision of mouth lesion complex 40816 CPT 40816 | $75.53 | $1,079.00 | $50.00 – $8,745.94 | 36 |
| Excision of neck cyst CPT 42815 | $131.81 | $1,883.00 | $84.51 – $15,616.06 | 36 |
| Excision of neck cyst confined 42810 CPT 42810 | $70.49 | $1,007.00 | $35.00 – $8,745.94 | 36 |
| Excision of penis lesion(s) 54060 CPT 54060 | $48.93 | $699.00 | $120.63 – $328.81 | 36 |
| Excision of rectal stricture CPT 45150 | $102.06 | $1,458.00 | $40.00 – $658.22 | 34 |
| Excision of salivary cyst CPT 42408 | $87.01 | $1,243.00 | $25.00 – $8,745.94 | 36 |
| Excision of stomach lesion CPT 43610 | $228.13 | $3,259.00 | $50.00 – $1,691.94 | 34 |
| Excision of stomach lesion CPT 43611 | $287.28 | $4,104.00 | $50.00 – $2,098.36 | 34 |
| Excision of tongue lesion CPT 41112 | $84.77 | $1,211.00 | $152.00 – $462.85 | 36 |
| Excision of tongue lesion CPT 41114 | $151.48 | $2,164.00 | $60.00 – $1,142.77 | 34 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | $90.37 | $1,291.00 | $152.00 – $510.31 | 30 |
| Excision of tonsil tags CPT 42860 | $48.72 | $696.00 | $30.00 – $331.93 | 34 |
| Excision of umbilicus 49250 CPT 49250 | $142.66 | $2,038.00 | $45.00 – $993.41 | 34 |
| Excision of uvula CPT 42140 | $77.63 | $1,109.00 | $20.00 – $340.38 | 36 |
| Excision of vaginal septum 57130 CPT 57130 | $42.00 | $600.00 | $25.00 – $378.88 | 34 |
| Excision olecranon bursa CPT 24105 | $374.57 | $5,351.00 | $202.53 – $8,631.30 | 36 |
| Excision radial head CPT 24130 | $128.24 | $1,832.00 | $27.00 – $991.87 | 34 |
| Excision tongue lesion without closure 41110 CPT 41110 | $57.12 | $816.00 | $50.00 – $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.