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 |
|---|---|---|---|---|
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $187.04 | $2,672.00 | $152.00 – $1,122.38 | 36 |
| Excis partial tal calc CPT 28120 | $122.36 | $1,748.00 | $30.00 – $1,060.68 | 34 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | $162.19 | $2,317.00 | $110.95 – $7,662.42 | 36 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | $114.24 | $1,632.00 | $73.72 – $7,662.42 | 36 |
| Exc les conjunctiva <1 cm CPT 68110 | $58.59 | $837.00 | $55.00 – $438.26 | 36 |
| Exc les conjunctiva >1 cm CPT 68115 | $81.83 | $1,169.00 | $152.00 – $352.69 | 18 |
| Exc les conjunctiva adj scl CPT 68130 | $101.64 | $1,452.00 | $236.78 – $1,027.83 | 34 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | $54.25 | $775.00 | $20.66 – $304.00 | 36 |
| Excl laa opn oth px any meth 33268 CPT 33268 | $26.32 | $376.00 | $74.00 – $194.97 | 33 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $81.20 | $1,160.00 | $17.00 – $304.00 | 36 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $81.20 | $1,160.00 | $17.00 – $379.06 | 36 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | $95.90 | $1,370.00 | $17.00 – $568.60 | 36 |
| Exc malig feenl >4cm 11646 CPT 11646 | $330.40 | $4,720.00 | $152.00 – $758.13 | 36 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $154.00 | $2,200.00 | $84.14 – $304.00 | 36 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | $81.20 | $1,160.00 | $126.58 – $304.00 | 36 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $154.00 | $2,200.00 | $20.00 – $408.85 | 36 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $65.80 | $940.00 | $20.00 – $304.00 | 36 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $70.00 | $1,000.00 | $35.00 – $304.00 | 36 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $61.18 | $874.00 | $84.51 – $324.91 | 36 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $81.20 | $1,160.00 | $152.00 – $376.36 | 36 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $89.95 | $1,285.00 | $35.00 – $416.97 | 36 |
| Exc mandible 21025 CPT 21025 | $164.85 | $2,355.00 | $295.98 – $1,862.73 | 34 |
| Exc neck tum deep < 5 cm CPT 21556 | $128.73 | $1,839.00 | $152.00 – $780.68 | 36 |
| Exc neck tum deep 5 cm/> CPT 21554 | $330.40 | $4,720.00 | $57.00 – $1,758.32 | 36 |
| Exc of rectal prlpse 45130 CPT 45130 | $256.76 | $3,668.00 | $611.32 – $1,873.06 | 34 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $330.40 | $4,720.00 | $47.00 – $7,662.42 | 36 |
| Exc prtl bn phlnx toe CPT 28124 | $118.86 | $1,698.00 | $152.00 – $786.97 | 36 |
| Exc rect tum transanal full CPT 45172 | $198.80 | $2,840.00 | $673.12 – $1,769.25 | 34 |
| Exc rect tum transanal part CPT 45171 | $150.50 | $2,150.00 | $25.00 – $7,321.98 | 36 |
| Exc sac pr ulc skn flp ostc CPT 15935 | $281.40 | $4,020.00 | $70.00 – $1,684.13 | 34 |
| Exc sacral pr ulc prim sutr CPT 15931 | $169.19 | $2,417.00 | $75.95 – $1,015.35 | 34 |
| Exc shoulder tum deep < 5 cm CPT 23076 | $330.40 | $4,720.00 | $97.91 – $7,662.42 | 36 |
| Exc skn hdrdnt ax complex CPT 11451 | $81.06 | $1,158.00 | $20.00 – $7,662.42 | 36 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | $280.00 | $4,000.00 | $36.00 – $7,662.42 | 36 |
| Exc skn hdrdnt ing complex CPT 11463 | $80.85 | $1,155.00 | $45.00 – $7,662.42 | 36 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $101.50 | $1,450.00 | $20.00 – $343.87 | 36 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $187.04 | $2,672.00 | $15.00 – $465.71 | 36 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | $99.61 | $1,423.00 | $40.00 – $584.84 | 36 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | $120.12 | $1,716.00 | $75.00 – $901.70 | 36 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $330.40 | $4,720.00 | $74.09 – $1,077.30 | 36 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $107.31 | $1,533.00 | $152.00 – $792.55 | 36 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | $116.48 | $1,664.00 | $38.00 – $1,234.36 | 36 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | $187.04 | $2,672.00 | $65.52 – $752.21 | 36 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | $99.54 | $1,422.00 | $68.13 – $994.25 | 36 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | $187.04 | $2,672.00 | $38.00 – $1,003.74 | 36 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | $330.40 | $4,720.00 | $68.88 – $1,006.11 | 36 |
| Exc sq tum/vasc malform/hand/fngr 26111 CPT 26111 | $187.04 | $2,672.00 | $63.00 – $4,356.78 | 36 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | $330.40 | $4,720.00 | $68.00 – $1,120.01 | 36 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | $184.87 | $2,641.00 | $152.00 – $1,167.47 | 36 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | $187.04 | $2,672.00 | $152.00 – $840.01 | 36 |
| Exc thigh/knee tum deep <5cm CPT 27328 | $151.13 | $2,159.00 | $40.00 – $7,662.42 | 36 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | $181.93 | $2,599.00 | $69.00 – $1,796.29 | 36 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $136.08 | $1,944.00 | $92.70 – $304.00 | 36 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | $187.04 | $2,672.00 | $60.00 – $484.07 | 36 |
| Exc torus mandibularis 21031 CPT 21031 | $95.97 | $1,371.00 | $152.00 – $685.77 | 36 |
| Exc trchntr pr ulc prim sutr CPT 15950 | $156.52 | $2,236.00 | $414.37 – $870.18 | 34 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $154.00 | $2,200.00 | $20.00 – $587.55 | 36 |
| Exc vagina lesion 57135 CPT 57135 | $60.62 | $866.00 | $20.00 – $407.82 | 36 |
| Exercise w/hemodynamic meas CPT 93464 | $14.98 | $214.00 | $90.15 – $257.71 | 34 |
| Ex palate/uvula lesion without closure 42104 CPT 42104 | $54.32 | $776.00 | $24.20 – $304.00 | 36 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $662.83 | $9,469.00 | $232.47 – $2,400.00 | 34 |
| Expl lap celiotomy w/wo bx 49000 CPT 49000 | $181.23 | $2,589.00 | $84.51 – $1,341.93 | 34 |
| Exploration carotid artery 35701 CPT 35701 | $103.18 | $1,474.00 | $65.00 – $988.33 | 36 |
| Exploration for testis CPT 54550 | $119.14 | $1,702.00 | $63.00 – $831.24 | 34 |
| Exploration maxillary sinus CPT 31030 | $128.03 | $1,829.00 | $26.00 – $1,115.32 | 34 |
| Exploration maxillary sinus CPT 31256 | $64.61 | $923.00 | $20.00 – $9,835.10 | 36 |
| Exploration of ankle joint CPT 27612 | $142.03 | $2,029.00 | $84.51 – $1,134.25 | 34 |
| Exploration of foot joint CPT 28020 | $89.67 | $1,281.00 | $35.00 – $875.91 | 34 |
| Exploration of foot joint CPT 28022 | $81.48 | $1,164.00 | $190.25 – $8,631.30 | 36 |
| Exploration of frontal sinus CPT 31070 | $118.44 | $1,692.00 | $59.00 – $861.56 | 34 |
| Exploration of knee joint CPT 27310 | $179.90 | $2,570.00 | $101.27 – $1,423.74 | 34 |
| Exploration of middle ear CPT 69440 | $169.82 | $2,426.00 | $421.82 – $1,079.15 | 34 |
| Exploration of sinuses CPT 31090 | $273.07 | $3,901.00 | $967.98 – $1,981.36 | 34 |
| Exploration of spinal fusion CPT 22830 | $197.19 | $2,817.00 | $85.00 – $1,596.96 | 34 |
| Exploration of toe joint CPT 28024 | $115.57 | $1,651.00 | $30.00 – $762.71 | 36 |
| Exploration/repair of rectum CPT 45562 | $275.87 | $3,941.00 | $35.00 – $1,873.06 | 34 |
| Exploration retroperitoneal area 49010 CPT 49010 | $215.39 | $3,077.00 | $30.00 – $17,077.46 | 36 |
| Explore adrenal gland w or without biopsy 60540 CPT 60540 | $254.52 | $3,636.00 | $40.00 – $2,228.17 | 34 |
| Explore chest vessels 35820 CPT 35820 | $455.56 | $6,508.00 | $40.00 – $3,580.98 | 36 |
| Explore deep node(s) neck CPT 38542 | $126.63 | $1,809.00 | $35.00 – $893.55 | 34 |
| Explore/irrigate tear ducts CPT 68840 | $33.18 | $474.00 | $15.00 – $304.00 | 36 |
| Explore limb vessels 35860 CPT 35860 | $191.10 | $2,730.00 | $62.17 – $1,127.57 | 34 |
| Explore neck vessels 35800 CPT 35800 | $173.32 | $2,476.00 | $70.00 – $965.69 | 34 |
| Explore parathyroid glands CPT 60500 | $230.02 | $3,286.00 | $25.00 – $15,616.06 | 36 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $138.11 | $1,973.00 | $152.00 – $1,086.79 | 36 |
| Explore/repair chest 32110 CPT 32110 | $341.18 | $4,874.00 | $60.00 – $3,167.43 | 36 |
| Explore scrotum CPT 55110 | $94.85 | $1,355.00 | $58.45 – $9,298.64 | 36 |
| Explore small intestine 44020 CPT 44020 | $228.06 | $3,258.00 | $116.53 – $1,666.74 | 34 |
| Explore/treat ankle joint CPT 27620 | $111.58 | $1,594.00 | $70.00 – $923.06 | 34 |
| Explore/treat eye socket CPT 67412 | $241.64 | $3,452.00 | $45.00 – $1,604.35 | 34 |
| Explore/treat finger joint CPT 26075 | $374.57 | $5,351.00 | $234.92 – $8,631.30 | 36 |
| Explore/treat finger joint CPT 26080 | $101.22 | $1,446.00 | $252.42 – $4,241.76 | 36 |
| Explore/treat knee joint CPT 27331 | $119.07 | $1,701.00 | $89.35 – $927.80 | 34 |
| Explore/treat wrist joint CPT 25101 | $102.55 | $1,465.00 | $65.00 – $837.63 | 34 |
| Explore wound abdomen 20102 CPT 20102 | $60.55 | $865.00 | $49.00 – $887.46 | 34 |
| Explore woundchest 20101 CPT 20101 | $49.35 | $705.00 | $19.00 – $730.85 | 34 |
| Explore wound neck 20100 CPT 20100 | $140.91 | $2,013.00 | $19.00 – $1,191.20 | 34 |
| Exp w remove/deep fb/forearm/wrist 25248 CPT 25248 | $103.88 | $1,484.00 | $412.72 – $4,241.76 | 36 |
| Ex sq tumor/face or scalp < 2 cm 21011 CPT 21011 | $187.04 | $2,672.00 | $75.00 – $802.04 | 36 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $187.04 | $2,672.00 | $85.00 – $823.40 | 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.