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 |
|---|---|---|---|---|
| Hpa-1 genotyping CPT 81105 | $7.60 | $108.64 | $108.64 – $1,290.14 | 23 |
| Hpv types 16 & 18 only CPT 87625 | $3.15 | $45.00 | $40.55 – $277.16 | 23 |
| H pylori (c-13) breath CPT 83013 | $67.34 | $962.00 | $59.88 – $703.40 | 23 |
| H pylori drug admin CPT 83014 | $6.51 | $93.00 | $7.86 – $86.02 | 23 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | $178.50 | $2,550.00 | $748.04 – $4,514.09 | 23 |
| Hrdtry cardmypy gene panel CPT 81439 | $123.90 | $1,770.00 | $584.90 – $5,155.39 | 23 |
| Hrdtry perph neurphy panel CPT 81448 | $105.00 | $1,500.00 | $584.90 – $5,682.24 | 23 |
| Htt gene detc abnor alleles CPT 81271 | $7.67 | $109.60 | $109.60 – $896.54 | 23 |
| Human epididymis protein 4 (he4) CPT 86305 | $10.13 | $144.72 | $18.50 – $279.60 | 23 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $97.73 | $1,396.12 | $0.25 – $1,995.06 | 10 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $29.56 | $422.28 | $3.99 – $603.44 | 11 |
| Hydration IV infusion each additional hour CPT 96361 | $60.97 | $871.00 | $13.85 – $123.52 | 36 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $103.81 | $1,483.00 | $35.97 – $561.09 | 36 |
| Hydrocolld drg <=16 without bdr HCPCS A6234 | $1.61 | $23.00 | $2.97 – $27.60 | 32 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $78.00 | $1,114.22 | $1.70 – $38.40 | 19 |
| Hydrogel drg > 48 sq in w/b HCPCS A6247 | $5.81 | $83.00 | $10.81 – $91.30 | 34 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $17.41 | $248.69 | $0.22 – $176.85 | 10 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $157.73 | $2,253.25 | $31.00 – $74.00 | 11 |
| Hydroxyurea 500 mg HCPCS S0176 | $1.67 | $23.91 | $1.08 – $34.17 | 8 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $5.74 | $82.00 | $5.91 – $34.80 | 19 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $5.75 | $82.13 | $6.50 – $186.40 | 23 |
| Hymenotomy CPT 56442 | $11.62 | $166.00 | $43.97 – $99.98 | 34 |
| Hyoid myotomy & suspension CPT 21685 | $237.79 | $3,397.00 | $50.00 – $1,917.30 | 34 |
| Hyperbaric oxygen therapy CPT 99183 | $59.36 | $848.00 | $92.90 – $445.00 | 37 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | $62.79 | $897.00 | $45.00 – $615.68 | 34 |
| Hysterosalpingography s&i CPT 74740 | $127.26 | $1,818.00 | $18.05 – $629.41 | 37 |
| Hysteroscopy ablation CPT 58563 | $57.82 | $826.00 | $30.00 – $13,196.08 | 36 |
| Hysteroscopy biopsy CPT 58558 | $367.08 | $5,244.00 | $65.00 – $637.60 | 36 |
| Hysteroscopy dx sep proc CPT 58555 | $84.42 | $1,206.00 | $132.30 – $491.34 | 36 |
| Hysteroscopy lysis CPT 58559 | $66.64 | $952.00 | $243.07 – $13,196.08 | 36 |
| Hysteroscopy remove fb CPT 58562 | $100.66 | $1,438.00 | $30.00 – $653.60 | 36 |
| Hysteroscopy remove myoma CPT 58561 | $83.86 | $1,198.00 | $163.00 – $13,196.08 | 36 |
| Hysteroscopy resect septum CPT 58560 | $73.29 | $1,047.00 | $267.77 – $870.70 | 34 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $52.22 | $746.00 | $78.35 – $490.80 | 14 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $69.16 | $988.00 | $31.93 – $1,411.85 | 10 |
| I131 iodide cap, rx HCPCS A9517 | $55.79 | $797.00 | $24.07 – $312.14 | 23 |
| Iaadi respiratory synctial virus CPT 87280 | $0.94 | $13.42 | $3.18 – $98.83 | 23 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $2.46 | $35.09 | $12.31 – $373.39 | 23 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $5.04 | $72.00 | $11.74 – $29.17 | 33 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $18.48 | $264.00 | $29.57 – $377.26 | 11 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $8,837.36 | $126,248.00 | $42,313.00 – $52,891.25 | 4 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $12,574.24 | $179,632.00 | $48,500.00 – $60,625.00 | 4 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $1,104.67 | $15,781.00 | $7,740.00 – $9,675.00 | 4 |
| Icut allergy test-delayed CPT 95028 | $2.24 | $32.00 | $4.20 – $19.47 | 34 |
| Icut allergy test drug/bug CPT 95024 | $1.40 | $20.00 | $0.88 – $155.62 | 37 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | $229.04 | $3,272.00 | $658.23 – $1,715.61 | 34 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | $93.17 | $1,331.00 | $30.00 – $718.38 | 34 |
| I&d/bursa/foot 28001 CPT 28001 | $23.03 | $329.00 | $53.00 – $4,356.78 | 36 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $374.57 | $5,351.00 | $91.21 – $1,049.36 | 36 |
| Idh1 common variants CPT 81120 | $10.82 | $154.60 | $154.60 – $1,652.28 | 23 |
| Idh2 common variants CPT 81121 | $16.56 | $236.63 | $236.63 – $2,529.06 | 23 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | $107.52 | $1,536.00 | $123.60 – $659.11 | 34 |
| I&d lacrimal sac CPT 68420 | $40.67 | $581.00 | $145.07 – $628.70 | 34 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $330.40 | $4,720.00 | $40.00 – $707.12 | 36 |
| I & d vag hematoma non-ob 57023 CPT 57023 | $76.65 | $1,095.00 | $12.00 – $647.25 | 34 |
| I&d vag hemtma obst/postpart CPT 57022 | $43.75 | $625.00 | $37.00 – $347.31 | 34 |
| Igh gene rearrange amp meth CPT 81261 | $14.70 | $210.00 | $115.00 – $886.62 | 22 |
| Igh@ var region somatic mutation analy CPT 81263 | $20.62 | $294.52 | $160.55 – $1,261.12 | 22 |
| Igk rearrangeabn clonal pop CPT 81264 | $13.30 | $190.00 | $135.00 – $2,668.53 | 22 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $30.87 | $441.00 | $25.87 – $469.63 | 24 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $10.50 | $150.00 | $21.14 – $945.55 | 36 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $19.95 | $285.00 | $19.28 – $449.42 | 36 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | $3.64 | $52.00 | $7.76 – $31.20 | 14 |
| Ikbkap gene CPT 81260 | $2.20 | $31.44 | $31.44 – $630.71 | 23 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | $243.88 | $3,484.00 | $407.00 – $1,816.11 | 34 |
| Iliac/fem angio cath insert HCPCS G0278 | $251.16 | $3,588.00 | $4.64 – $93.07 | 35 |
| Immob elbow child sm HCPCS L3762 | $20.16 | $288.00 | $52.55 – $334.08 | 32 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $29.12 | $416.00 | $48.70 – $482.56 | 34 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $21.21 | $303.00 | $49.17 – $161.24 | 34 |
| Immobilizer shldr sling med HCPCS L3660 | $23.45 | $335.00 | $44.27 – $388.60 | 34 |
| Immt breast prosthesis 19340 CPT 19340 | $184.80 | $2,640.00 | $35.00 – $1,325.62 | 34 |
| Immune complex assay CPT 86332 | $1.71 | $24.37 | $7.99 – $267.98 | 23 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $34.37 | $491.00 | $5.09 – $228.67 | 23 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $17.29 | $247.00 | $5.09 – $228.67 | 23 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $1.55 | $22.18 | $4.19 – $131.77 | 23 |
| Immunodiffusion nes CPT 86329 | $0.98 | $14.05 | $4.17 – $141.02 | 23 |
| Immunofixation electrophoresis serum CPT 86334 | $1.56 | $22.34 | $5.71 – $245.62 | 23 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $6.99 | $99.84 | $33.83 – $586.74 | 24 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $63.84 | $911.97 | $74.69 – $449.42 | 24 |
| Immunoglobulin assay CPT 86023 | $6.22 | $88.90 | $4.01 – $118.07 | 23 |
| Immunology procedure CPT 86849 | $4.67 | $66.75 | $66.75 – $95.39 | 5 |
| Impact tooth remov part bony HCPCS D7230 | $48.02 | $686.00 | $152.00 – $980.29 | 17 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $662.83 | $9,469.00 | $1,313.00 – $1,876.28 | 5 |
| Implant hormone pellet(s) 11980 CPT 11980 | $12.95 | $185.00 | $14.00 – $1,178.42 | 36 |
| Implant neuroelectrodes CPT 63655 | $200.69 | $2,867.00 | $155.25 – $1,976.64 | 34 |
| Implant neuroelectrodes CPT 64561 | $72.31 | $1,033.00 | $40.00 – $16,811.48 | 36 |
| Implant spine infusion pump CPT 62362 | $92.68 | $1,324.00 | $65.00 – $47,545.60 | 36 |
| Implant ureth bulk agent HCPCS L8606 | $483.00 | $6,900.00 | $118.40 – $792.28 | 34 |
| Impl neurostim electr perc CPT 63650 | $100.17 | $1,431.00 | $378.30 – $16,811.48 | 36 |
| Implnt bio implnt for soft tiss reinforcement 15777 CPT 15777 | $50.40 | $720.00 | $30.00 – $355.90 | 36 |
| Implnt spinl canal catheter 62350 CPT 62350 | $96.18 | $1,374.00 | $52.12 – $23,150.00 | 36 |
| Imp neurosti pls gn any type HCPCS L8679 | $12,847.52 | $183,536.00 | $10,529.94 – $204,945.00 | 16 |
| In-111 autol wbc diag per dose HCPCS A9570 | $300.65 | $4,295.00 | $1,103.19 – $3,003.43 | 16 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $312.48 | $4,464.00 | $151.11 – $2,263.65 | 22 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $411.95 | $5,885.00 | $141.06 – $2,029.95 | 22 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | $146.16 | $2,088.00 | $60.00 – $1,596.96 | 34 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | $128.10 | $1,830.00 | $502.16 – $982.38 | 34 |
| Incis 1 vertebral seg cerv CPT 22210 | $423.15 | $6,045.00 | $967.00 – $3,457.32 | 34 |
| Incis 1 vertebral seg lumbar CPT 22214 | $361.48 | $5,164.00 | $65.00 – $2,880.70 | 34 |
| Incis 1 vertebral seg thorac CPT 22212 | $361.83 | $5,169.00 | $40.00 – $2,845.11 | 34 |
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.