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 |
|---|---|---|---|---|
| Foot arch support remov prem HCPCS L3030 | $15.68 | $224.00 | $40.98 – $268.80 | 32 |
| Foot plas heel stabi pre ots HCPCS L3170 | $10.50 | $150.00 | $27.32 – $180.00 | 32 |
| Foot X-ray CPT 73630 | $147.21 | $2,103.00 | $8.15 – $229.57 | 37 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | $231.91 | $3,313.00 | $495.79 – $3,843.08 | 32 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $28.42 | $406.00 | $41.31 – $659.08 | 36 |
| Fracture assessment via dxa CPT 77086 | $2.24 | $32.00 | $8.15 – $37.59 | 34 |
| Fragmenting of kidney stone CPT 50590 | $138.39 | $1,977.00 | $25.00 – $9,298.64 | 36 |
| Freeing of bowel adhesion 44005 CPT 44005 | $254.66 | $3,638.00 | $122.11 – $1,891.98 | 34 |
| Free/remove chest lining 32320 CPT 32320 | $368.76 | $5,268.00 | $90.00 – $3,464.51 | 34 |
| Frenectomy 41115 CPT 41115 | $64.68 | $924.00 | $20.66 – $322.71 | 36 |
| Frenotomy 40806 CPT 40806 | $25.69 | $367.00 | $15.00 – $304.00 | 36 |
| Frenulotomy of penis CPT 54164 | $48.09 | $687.00 | $60.00 – $5,514.28 | 36 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $5.25 | $75.00 | $73.77 – $689.00 | 21 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $6.09 | $87.00 | $85.98 – $689.00 | 21 |
| Fresh frozen plasma thawing ea un CPT 86927 | $28.35 | $405.00 | $2.38 – $449.42 | 18 |
| Fructosamine glycated protein CPT 82985 | $1.17 | $16.76 | $5.56 – $165.75 | 23 |
| Fth/gft fr n/e/e/l each addl CPT 15261 | $32.13 | $459.00 | $112.03 – $314.08 | 36 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $248.71 | $3,553.00 | $30.00 – $1,383.58 | 36 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | $149.87 | $2,141.00 | $60.00 – $5,442.78 | 36 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | $16.24 | $232.00 | $35.00 – $216.61 | 36 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $230.65 | $3,295.00 | $152.00 – $1,307.77 | 36 |
| Fundus photography with i&r 92250 CPT 92250 | $14.63 | $209.00 | $21.11 – $350.97 | 36 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $11.20 | $160.00 | $0.02 – $16.80 | 15 |
| Fuse/graft added joint CPT 26863 | $53.34 | $762.00 | $126.58 – $486.44 | 34 |
| Fuse pancreas and bowel CPT 48548 | $388.08 | $5,544.00 | $80.00 – $2,873.53 | 34 |
| Fusion/graft of finger joint CPT 26862 | $190.82 | $2,726.00 | $61.00 – $1,506.79 | 34 |
| Fusion/graft of hand joint CPT 26844 | $212.66 | $3,038.00 | $421.82 – $1,696.62 | 34 |
| Fusion of ankle joint open CPT 27870 | $244.37 | $3,491.00 | $80.00 – $2,092.90 | 34 |
| Fusion of big toe joint CPT 28750 | $141.47 | $2,021.00 | $299.33 – $19,141.34 | 36 |
| Fusion of big toe joint CPT 28755 | $83.65 | $1,195.00 | $70.00 – $851.65 | 34 |
| Fusion of finger jnt add-on CPT 26861 | $23.94 | $342.00 | $61.00 – $218.31 | 34 |
| Fusion of finger joint CPT 26860 | $153.93 | $2,199.00 | $265.45 – $1,188.82 | 34 |
| Fusion of finger tendons CPT 26471 | $165.27 | $2,361.00 | $295.23 – $1,283.74 | 34 |
| Fusion of finger tendons CPT 26474 | $162.75 | $2,325.00 | $60.00 – $1,248.15 | 34 |
| Fusion of foot bones CPT 28730 | $177.87 | $2,541.00 | $463.89 – $1,600.89 | 34 |
| Fusion of foot bones CPT 28735 | $190.33 | $2,719.00 | $590.10 – $1,536.21 | 34 |
| Fusion of foot bones CPT 28740 | $151.20 | $2,160.00 | $30.00 – $1,525.43 | 34 |
| Fusion of knee CPT 27580 | $355.53 | $5,079.00 | $168.65 – $2,899.68 | 34 |
| Fusion of knuckle CPT 26850 | $182.91 | $2,613.00 | $31.00 – $1,456.96 | 34 |
| Fusion of knuckle joint CPT 26516 | $185.15 | $2,645.00 | $35.00 – $1,473.57 | 34 |
| Fusion of knuckle with graft CPT 26852 | $207.13 | $2,959.00 | $26.00 – $1,642.05 | 34 |
| Fusion of tendons at wrist CPT 25300 | $170.87 | $2,441.00 | $70.00 – $1,378.65 | 34 |
| Fusion of tendons at wrist CPT 25301 | $159.53 | $2,279.00 | $40.00 – $1,319.33 | 34 |
| Fusion of thumb CPT 26841 | $192.36 | $2,748.00 | $61.00 – $1,544.76 | 34 |
| Fusion of tibiofibular joint CPT 27871 | $168.84 | $2,412.00 | $50.00 – $1,381.03 | 34 |
| Fusion of toes CPT 28280 | $123.41 | $1,763.00 | $206.25 – $900.16 | 34 |
| Fusion of ureter & kidney CPT 50740 | $286.58 | $4,094.00 | $75.00 – $1,901.85 | 34 |
| G0180 home health certification HCPCS G0180 | $9.80 | $140.00 | $17.30 – $86.81 | 32 |
| G6pd full gene sequence CPT 81249 | $63.00 | $900.00 | $600.00 – $4,721.44 | 22 |
| G6pd gene alys cmn variant CPT 81247 | $12.24 | $174.81 | $174.81 – $1,375.57 | 22 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $41.86 | $598.00 | $12.59 – $854.54 | 10 |
| Gabapentin non-blood CPT 80355 | $1.12 | $16.00 | $0.03 – $133.54 | 8 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $0.91 | $13.00 | $2.01 – $18.58 | 10 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $0.22 | $3.18 | $0.26 – $4.54 | 10 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $8.59 | $122.78 | $7.85 – $231.70 | 23 |
| Galactose transferase test CPT 82776 | $1.12 | $15.95 | $2.51 – $92.16 | 23 |
| Galectin-3 CPT 82777 | $3.10 | $44.25 | $42.03 – $107.93 | 22 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $156.17 | $2,231.00 | $93.08 – $1,476.30 | 34 |
| Gammaglobulin iga CPT 82784 | $23.52 | $336.00 | $1.68 – $85.21 | 23 |
| Gammaglobulin ige CPT 82785 | $16.38 | $234.00 | $6.10 – $181.07 | 23 |
| Gamma glutamyltransferase CPT 82977 | $41.58 | $594.00 | $2.48 – $79.51 | 23 |
| Gastric emptying imag study CPT 78265 | $12.46 | $178.00 | $45.59 – $467.71 | 34 |
| Gastroduodenostomy CPT 43810 | $237.58 | $3,394.00 | $55.00 – $1,733.91 | 34 |
| Gastroesophageal reflux study CPT 78262 | $8.89 | $127.00 | $31.92 – $306.68 | 34 |
| Gastroesophageal reflux test CPT 91034 | $345.38 | $4,934.00 | $51.65 – $1,828.16 | 37 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | $314.23 | $4,489.00 | $524.00 – $2,175.67 | 34 |
| Gastrojejunostomy w/vagotomy CPT 43825 | $306.11 | $4,373.00 | $141.85 – $2,237.51 | 34 |
| Gastro/jejuno tube, std HCPCS B4087 | $101.01 | $1,443.00 | $40.46 – $1,803.75 | 5 |
| Gated heart multiple CPT 78473 | $18.83 | $269.00 | $69.42 – $373.63 | 34 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | $0.56 | $8.00 | $1.10 – $9.60 | 32 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | $0.49 | $7.00 | $0.97 – $8.40 | 32 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | $0.91 | $13.00 | $1.64 – $15.60 | 32 |
| Gba gene CPT 81251 | $3.31 | $47.25 | $47.25 – $1,184.65 | 22 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $0.84 | $12.00 | $0.56 – $5.80 | 31 |
| General health panel CPT 80050 | $47.81 | $683.00 | $68.09 – $508.72 | 10 |
| Generator barostim neo2 2014 HCPCS C1767 | $10,492.93 | $149,899.00 | $74.00 – $36,000.00 | 9 |
| Generator emblem MRI sicd subq HCPCS C1722 | $3,314.01 | $47,343.00 | $34,130.00 – $42,662.50 | 4 |
| Genetic tstg severe inh cond CPT 81443 | $119.18 | $1,702.50 | $1,702.50 – $16,023.37 | 22 |
| Genome sequence analysis CPT 81425 | $217.00 | $3,100.00 | $0.03 – $22,668.84 | 22 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $14.43 | $206.20 | $2.07 – $6.00 | 19 |
| Gentamicin peak therapeutic drug level CPT 80170 | $31.08 | $444.00 | $6.06 – $163.23 | 23 |
| G-esoph reflx tst w/electrod CPT 91035 | $307.65 | $4,395.00 | $86.83 – $3,847.54 | 37 |
| Ghs abscess perianal iandd CPT 46050 | $105.28 | $1,504.00 | $79.67 – $304.00 | 36 |
| Ghs abscess postoperative iandd complex CPT 10180 | $330.40 | $4,720.00 | $117.65 – $341.16 | 36 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $0.69 | $9.81 | $2.75 – $84.46 | 23 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $9.24 | $132.00 | $5.95 – $176.70 | 23 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | $54.60 | $780.00 | $102.26 – $1,037.04 | 23 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $6.51 | $93.00 | $16.09 – $78.80 | 34 |
| Ghs antibodies (torch) igm CPT 86694 | $1.01 | $14.39 | $4.23 – $157.75 | 23 |
| Ghs bladder cath - complex-foley CPT 51703 | $36.75 | $525.00 | $66.62 – $304.00 | 36 |
| Ghs bleeding time (ivy) CPT 85002 | $0.34 | $4.82 | $1.54 – $49.60 | 23 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $27.37 | $391.00 | $12.00 – $304.00 | 36 |
| Ghs central line insert < age 5, failed CPT 36555 | $19.67 | $281.00 | $78.81 – $8,329.20 | 36 |
| Ghs change cysto/gastrost CPT 43762 | $164.78 | $2,354.00 | $32.97 – $697.98 | 36 |
| Ghs chemo >8 hrs CPT 96416 | $23.73 | $339.00 | $46.19 – $362.58 | 34 |
| Ghs chemo infusion >8 hrs CPT 96425 | $29.33 | $419.00 | $153.04 – $360.22 | 34 |
| Ghs chemo IV push, ea addtl CPT 96411 | $9.52 | $136.00 | $17.96 – $140.12 | 34 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $2.46 | $35.09 | $12.31 – $373.39 | 23 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $74.97 | $1,071.00 | $15.00 – $500.68 | 36 |
| Ghs closed reduction ankle dislocation CPT 27840 | $97.65 | $1,395.00 | $170.32 – $675.95 | 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.