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 |
|---|---|---|---|---|
| Ext ecg>48hr<7d rev&interpj CPT 93244 | $3.92 | $56.00 | $21.06 – $239.40 | 37 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $43.26 | $618.00 | $52.41 – $390.69 | 33 |
| Ext ecg>7d<15d rec scan a/r CPT 93245 | $51.38 | $734.00 | $74.00 – $630.42 | 35 |
| Ext ecg>7d<15d rev&interpj CPT 93248 | $4.34 | $62.00 | $23.17 – $263.76 | 37 |
| Ext ecg>7d<15d scan a/r CPT 93247 | $44.87 | $641.00 | $52.41 – $404.03 | 33 |
| Extended visual field xm CPT 92083 | $11.41 | $163.00 | $22.14 – $350.97 | 36 |
| Extensive ear canal surgery 69150 CPT 69150 | $244.16 | $3,488.00 | $65.00 – $15,616.06 | 36 |
| Extensive prostate surgery CPT 55840 | $279.23 | $3,989.00 | $70.00 – $2,299.06 | 36 |
| Extensive prostate surgery CPT 55842 | $278.74 | $3,982.00 | $45.00 – $2,464.78 | 34 |
| Extensive prostate surgery CPT 55845 | $323.82 | $4,626.00 | $267.31 – $2,827.79 | 36 |
| Extensive surgery of throat CPT 42842 | $247.17 | $3,531.00 | $71.00 – $1,650.15 | 34 |
| Extensive testis surgery CPT 54535 | $178.99 | $2,557.00 | $40.00 – $1,273.16 | 34 |
| Extensive thyroid surgery CPT 60254 | $393.05 | $5,615.00 | $65.00 – $3,590.21 | 34 |
| External cannula declotting CPT 36860 | $24.99 | $357.00 | $80.00 – $279.11 | 34 |
| External chromosome analysis 20-25 cells CPT 88264 | $13.00 | $185.65 | $144.61 – $1,364.39 | 24 |
| External newborn metabolic screening panel HCPCS S3620 | $13.30 | $190.00 | $16.73 – $155.38 | 11 |
| External ocular photography CPT 92285 | $4.20 | $60.00 | $2.98 – $98.53 | 37 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $28.00 | $400.00 | $95.00 – $1,179.03 | 24 |
| Extnd color vision xm CPT 92283 | $1.47 | $21.00 | $8.88 – $155.62 | 37 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $5.99 | $85.50 | $4.19 – $167.45 | 23 |
| Extraction erupted tooth/exr HCPCS D7140 | $15.05 | $215.00 | $152.00 – $307.24 | 17 |
| Extraction of lens CPT 66940 | $191.45 | $2,735.00 | $690.32 – $1,380.00 | 34 |
| Face bone graft CPT 21210 | $188.51 | $2,693.00 | $148.92 – $3,186.80 | 34 |
| Facial bones <3 CPT 70140 | $95.34 | $1,362.00 | $9.93 – $229.57 | 37 |
| Factor ix CPT 85250 | $1.33 | $19.04 | $7.08 – $209.35 | 23 |
| Factor viii CPT 85240 | $12.60 | $180.00 | $6.64 – $196.91 | 23 |
| Fallopian tube recnl CPT 58345 | $69.23 | $989.00 | $252.44 – $1,186.80 | 34 |
| Family therapy without pt 50min 90846 CPT 90846 | $17.50 | $250.00 | $86.64 – $186.19 | 34 |
| Family therapy with patient 50 min 90847 CPT 90847 | $18.27 | $261.00 | $123.45 – $304.00 | 18 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $8.98 | $128.22 | $0.02 – $183.23 | 10 |
| Fancc gene CPT 81242 | $2.56 | $36.62 | $36.62 – $509.16 | 22 |
| Fasciotomy hip/thigh any typ CPT 27025 | $228.83 | $3,269.00 | $421.82 – $1,729.84 | 34 |
| Fat/lipids feces qualitative CPT 82705 | $0.36 | $5.10 | $1.94 – $56.04 | 23 |
| Fatty acids nonesterified CPT 82725 | $1.31 | $18.77 | $4.90 – $146.43 | 23 |
| #fecal-sodium CPT 84302 | $3.43 | $49.00 | $1.18 – $53.23 | 23 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $1.06 | $15.14 | $14.91 – $69.51 | 23 |
| Femoral endovas graft add-on 34813 CPT 34813 | $51.45 | $735.00 | $70.00 – $452.98 | 34 |
| Feno poc CPT 95012 | $3.43 | $49.00 | $18.75 – $32.44 | 34 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $153.70 | $2,195.67 | $0.54 – $212.99 | 11 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $1,410.93 | $20,156.10 | $0.65 – $11.46 | 23 |
| Ferritin CPT 82728 | $46.69 | $667.00 | $4.34 – $149.83 | 23 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $303.24 | $4,332.00 | $51.28 – $394.81 | 37 |
| Fetal chrmoml microdeltj CPT 81422 | $19.25 | $275.00 | $45.00 – $5,155.39 | 22 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $31.50 | $450.00 | $275.00 – $3,290.06 | 23 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $124.39 | $1,777.00 | $5.00 – $304.00 | 36 |
| Fetal fibronectin CPT 82731 | $111.93 | $1,599.00 | $15.48 – $1,480.54 | 23 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $13.23 | $189.00 | $2.77 – $85.06 | 23 |
| Fetal hemoglobin rosette CPT 85461 | $28.63 | $409.00 | $2.35 – $168.19 | 23 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $1.35 | $19.32 | $1.43 – $62.87 | 23 |
| Fetal non stress test CPT 59025 | $80.71 | $1,153.00 | $3.00 – $533.31 | 36 |
| #_fet/norfentcnfrmur CPT 80354 | $35.63 | $509.00 | $0.03 – $196.47 | 8 |
| Fibrin degradation d dimer quantitative CPT 85379 | $52.92 | $756.00 | $3.70 – $111.85 | 23 |
| Fibrin degradation products CPT 85362 | $0.48 | $6.89 | $1.68 – $75.66 | 23 |
| Fibrin degrade semiquant CPT 85378 | $0.68 | $9.72 | $2.55 – $81.87 | 23 |
| Fibrinogen activity CPT 85384 | $73.29 | $1,047.00 | $3.04 – $92.83 | 23 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $2.80 | $40.00 | $5.63 – $35.21 | 33 |
| Fibrinolytic antiplasmin CPT 85410 | $0.54 | $7.71 | $2.77 – $82.10 | 23 |
| Fibrinolytic plasminogen CPT 85415 | $1.07 | $15.28 | $6.38 – $189.14 | 23 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $0.46 | $6.53 | $1.68 – $71.95 | 23 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $277.78 | $3,968.28 | $0.32 – $10.21 | 23 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $0.21 | $3.00 | $1.00 – $3.48 | 18 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $914.20 | $13,060.00 | $9,381.00 – $11,726.25 | 4 |
| Filter vena cava fem denali HCPCS C1880 | $751.17 | $10,731.00 | $2,004.00 – $2,505.00 | 4 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $20.93 | $299.00 | $37.00 – $462.61 | 33 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $12.81 | $183.00 | $22.00 – $81.75 | 35 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $152.53 | $2,179.00 | $42.58 – $94.31 | 35 |
| Fine needle asp without image guide 10021 CPT 10021 | $194.18 | $2,774.00 | $22.00 – $304.00 | 35 |
| Finger tendon transfer CPT 26497 | $223.09 | $3,187.00 | $84.51 – $1,777.30 | 34 |
| Finger tendon transfer CPT 26498 | $287.98 | $4,114.00 | $65.00 – $2,351.54 | 34 |
| Fitting of diaphragm/cap 57170 CPT 57170 | $18.83 | $269.00 | $3.00 – $304.00 | 36 |
| Fixation of ankle joint CPT 27860 | $40.46 | $578.00 | $75.00 – $351.19 | 34 |
| Fixation of knee joint CPT 27570 | $38.57 | $551.00 | $54.00 – $284.75 | 34 |
| Fixation of shoulder blade CPT 23400 | $236.39 | $3,377.00 | $70.00 – $1,938.66 | 34 |
| Fix g/colon tube w/device CPT 49460 | $364.91 | $5,213.00 | $679.82 – $2,392.56 | 18 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $167.02 | $2,386.00 | $17.00 – $8,631.30 | 36 |
| Flecainide (tambocor)-sendout CPT 80181 | $1.30 | $18.64 | $14.91 – $69.51 | 23 |
| Fl exam g/colon tube w contrast CPT 49465 | $157.92 | $2,256.00 | $25.48 – $629.41 | 36 |
| Flexible Sigmoidoscopy CPT 45330 | $105.28 | $1,504.00 | $25.00 – $304.00 | 36 |
| Floor of mouth biopsy 41108 CPT 41108 | $42.28 | $604.00 | $55.00 – $304.00 | 36 |
| Flow cytometry marker each additional CPT 88185 | $27.30 | $390.00 | $8.67 – $210.75 | 24 |
| Flow cytometry one marker technical component CPT 88184 | $26.18 | $374.00 | $42.18 – $945.55 | 24 |
| Flt3 gene CPT 81245 | $9.27 | $132.40 | $132.40 – $659.65 | 23 |
| Flt3 gene analysis CPT 81246 | $4.65 | $66.40 | $66.40 – $1,225.22 | 23 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $30.48 | $435.50 | $10.08 – $414.49 | 10 |
| Fluidotherapy charges pt CPT 97022 | $5.46 | $78.00 | $11.14 – $33.14 | 36 |
| Fluid pressure muscle 20950 CPT 20950 | $21.56 | $308.00 | $84.16 – $1,868.00 | 30 |
| Flulaval vacc, 3 yrs & >, im HCPCS Q2036 | $3.85 | $55.00 | $3.66 – $66.00 | 15 |
| Fluorescein angrph mltiframe CPT 92235 | $7.35 | $105.00 | $43.65 – $569.59 | 36 |
| Fluorescent antibody titer dna CPT 86256 | $16.45 | $235.00 | $4.42 – $132.58 | 23 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $197.19 | $2,817.00 | $23.49 – $363.90 | 36 |
| Fluoroguide needle placement CPT 77002 | $159.74 | $2,282.00 | $26.56 – $476.36 | 36 |
| Fluoro polarize fetal lung CPT 83663 | $1.32 | $18.91 | $2.88 – $103.93 | 23 |
| Fluoroscopy up to 1 hour CPT 76000 | $190.47 | $2,721.00 | $9.91 – $629.41 | 37 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | $3.85 | $55.00 | $17.52 – $66.00 | 14 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,178.80 | $16,840.00 | $37.00 – $1,868.00 | 35 |
| Folic acid CPT 82746 | $56.07 | $801.00 | $5.43 – $161.68 | 23 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $1.12 | $16.00 | $0.07 – $22.86 | 10 |
| Follow-up angiography CPT 75898 | $426.58 | $6,094.00 | $67.72 – $8,329.20 | 37 |
| Followup eval of foot pt lop HCPCS G0246 | $6.93 | $99.00 | $9.76 – $304.00 | 34 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,057.00 | $15,100.00 | $0.62 – $44.64 | 23 |
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.