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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $28.21 | $403.00 | $12.31 – $336.05 | 36 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $2.46 | $35.09 | $30.54 – $222.16 | 23 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $28.21 | $403.00 | $70.18 – $140.36 | 19 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $28.98 | $414.00 | $74.92 – $181.26 | 22 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | $86.73 | $1,239.00 | $679.77 – $1,359.54 | 19 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $276.29 | $3,947.00 | $370.47 – $3,291.76 | 23 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $85.19 | $1,217.00 | $114.04 – $1,013.21 | 23 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $18.41 | $262.99 | $210.39 – $1,685.67 | 23 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $8.37 | $119.50 | $16.12 – $284.49 | 23 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $3.00 | $42.84 | $16.12 – $284.49 | 23 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $3.00 | $42.84 | $16.12 – $284.49 | 23 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $6.55 | $93.50 | $28.46 – $284.49 | 23 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $120.26 | $1,718.00 | $16.81 – $1,069.10 | 23 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,045.55 | $14,936.49 | $31.48 – $130.91 | 23 |
| Influenza dna amp prob addl CPT 87503 | $14.28 | $204.00 | $6.22 – $173.30 | 23 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | $14.63 | $209.00 | $76.95 – $250.80 | 13 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | $5.46 | $78.00 | $12.00 – $52.80 | 14 |
| Ingest challenge ea addl 60 min CPT 95079 | $15.19 | $217.00 | $58.39 – $176.89 | 34 |
| Ingest challenge ini 120 min CPT 95076 | $22.33 | $319.00 | $63.38 – $258.31 | 34 |
| Initial foot exam pt lops HCPCS G0245 | $11.34 | $162.00 | $16.62 – $304.00 | 34 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | $59.15 | $845.00 | $152.00 – $622.20 | 36 |
| Initial nursing facility care/day 35 minutes CPT 99305 | $23.59 | $337.00 | $46.90 – $242.92 | 36 |
| Initial nursing facility care/day 45 minutes CPT 99306 | $32.20 | $460.00 | $72.10 – $304.00 | 36 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | $14.21 | $203.00 | $37.80 – $144.66 | 36 |
| Initiation & management bipap/cpap initial day CPT 94660 | $295.68 | $4,224.00 | $32.43 – $577.64 | 37 |
| Init nb em per day non-fac CPT 99461 | $10.64 | $152.00 | $53.57 – $175.88 | 34 |
| Init pm e/m new pat 65+ yrs CPT 99387 | $24.43 | $349.00 | $136.54 – $351.60 | 27 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | $40.95 | $585.00 | $121.26 – $678.60 | 18 |
| Inj cefazolin sodium, baxter HCPCS J0689 | $13.57 | $193.84 | $1.38 – $276.99 | 10 |
| Inj, clindamycin (baxter) HCPCS J0737 | $24.24 | $346.25 | $2.43 – $494.79 | 10 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $218.61 | $3,123.00 | $33.86 – $377.29 | 36 |
| Inj, donanemab-azbt, 2 mg HCPCS J0175 | $272.05 | $3,886.38 | $2.21 – $11.35 | 22 |
| Inj dupuytren cord w/enzyme CPT 20527 | $21.63 | $309.00 | $49.14 – $304.00 | 36 |
| Inj, durolane 1 mg HCPCS J7318 | $74.62 | $1,066.00 | $6.52 – $1,236.56 | 18 |
| Inj dx for sinogram CPT 20501 | $147.00 | $2,100.00 | $15.00 – $265.76 | 36 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $19.81 | $283.00 | $23.00 – $473.72 | 34 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $120.05 | $1,715.00 | $57.17 – $415.26 | 36 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $68.18 | $974.00 | $3.00 – $304.00 | 36 |
| Injection during cath supravalvular aortography CPT 93567 | $219.94 | $3,142.00 | $30.72 – $525.09 | 36 |
| Injection epidural blood patch or clot CPT 62273 | $271.11 | $3,873.00 | $18.00 – $1,862.06 | 36 |
| Injection eye drug CPT 67028 | $27.79 | $397.00 | $75.00 – $399.13 | 36 |
| Injection for arthrography wrist (both sides) CPT 25246 | $182.00 | $2,600.00 | $35.00 – $358.31 | 36 |
| Injection for bladder x-ray CPT 51600 | $123.20 | $1,760.00 | $10.00 – $365.64 | 36 |
| Injection for hip x-ray CPT 27095 | $19.25 | $275.00 | $68.54 – $514.92 | 34 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $159.74 | $2,282.00 | $15.00 – $322.71 | 36 |
| Injection for ureter x-ray CPT 50690 | $17.01 | $243.00 | $20.00 – $186.77 | 34 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $2,351.94 | $33,599.16 | $6.42 – $34.55 | 22 |
| Injection into brain canal CPT 61055 | $27.44 | $392.00 | $97.72 – $225.43 | 34 |
| Injection into hemorrhoid(s) CPT 46500 | $46.20 | $660.00 | $15.00 – $2,453.16 | 36 |
| Injection into vocal cord CPT 31513 | $31.57 | $451.00 | $113.63 – $1,031.74 | 36 |
| Injection of sinus tract CPT 20500 | $22.26 | $318.00 | $10.00 – $253.90 | 34 |
| Injection,onabotulinumtoxina HCPCS J0585 | $212.17 | $3,031.06 | $2.47 – $15.08 | 31 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $7.56 | $108.00 | $27.05 – $84.56 | 34 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $79.94 | $1,142.00 | $10.00 – $304.00 | 36 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $18.48 | $264.00 | $38.86 – $304.00 | 36 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $527.73 | $7,539.00 | $12.00 – $405.94 | 36 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $24.08 | $344.00 | $50.60 – $186.99 | 36 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $38.29 | $547.00 | $95.38 – $2,333.18 | 36 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $455.56 | $6,508.00 | $12.00 – $170.37 | 36 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $340.83 | $4,869.00 | $12.00 – $2,333.18 | 36 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $25.83 | $369.00 | $23.00 – $1,862.06 | 36 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $168.77 | $2,411.00 | $18.00 – $1,862.06 | 36 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $68.18 | $974.00 | $3.00 – $304.00 | 36 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $141.33 | $2,019.00 | $36.17 – $304.00 | 36 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $68.18 | $974.00 | $41.24 – $304.00 | 36 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $55.30 | $790.00 | $16.75 – $123.52 | 36 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $49.21 | $703.00 | $703.00 – $1,004.59 | 8 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $56.91 | $813.00 | $40.52 – $561.09 | 36 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $45.43 | $649.00 | $16.20 – $189.93 | 36 |
| Injection treatment of eye CPT 66030 | $27.51 | $393.00 | $45.00 – $6,087.86 | 36 |
| Injection treatment of nerve CPT 64605 | $219.03 | $3,129.00 | $152.00 – $314.00 | 18 |
| Injection treatment of nerve CPT 64610 | $184.17 | $2,631.00 | $152.00 – $405.18 | 18 |
| Injection treatment of nerve CPT 64681 | $113.26 | $1,618.00 | $45.00 – $576.86 | 36 |
| Injection treatment of nose CPT 30200 | $27.44 | $392.00 | $31.65 – $304.00 | 36 |
| Inject sacroiliac joint CPT 27096 | $402.50 | $5,750.00 | $17.00 – $403.39 | 36 |
| Inject/treat eye socket CPT 67515 | $11.34 | $162.00 | $39.05 – $837.29 | 36 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $23.45 | $335.00 | $87.71 – $1,862.06 | 36 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $18.62 | $266.00 | $23.00 – $2,333.18 | 36 |
| Inj for ext venography CPT 36005 | $369.46 | $5,278.00 | $40.31 – $574.24 | 36 |
| Inj for mammo ductogram CPT 19030 | $17.78 | $254.00 | $40.00 – $255.44 | 36 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | $1.26 | $18.00 | $6.18 – $25.72 | 9 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $323.33 | $4,619.00 | $38.66 – $579.94 | 36 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $8.40 | $120.00 | $43.11 – $187.97 | 34 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $8.89 | $127.00 | $45.04 – $190.68 | 34 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $5.04 | $72.00 | $22.09 – $144.28 | 34 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $5.04 | $72.00 | $21.74 – $645.20 | 34 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $34.58 | $494.00 | $132.12 – $568.48 | 34 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $23.03 | $329.00 | $4.00 – $304.00 | 36 |
| Inj intralesional > 7 lsns CPT 11901 | $17.36 | $248.00 | $30.53 – $304.00 | 36 |
| Inj ivig privigen 500 mg HCPCS J1459 | $4,602.32 | $65,747.38 | $25.21 – $136.88 | 23 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | $594.75 | $8,496.46 | $0.73 – $8.30 | 22 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $29.22 | $417.44 | $0.01 – $3.30 | 15 |
| Inj naloxone hydrochloride HCPCS J2310 | $12.18 | $174.00 | $0.01 – $28.80 | 12 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $286.30 | $4,090.00 | $45.00 – $1,839.42 | 36 |
| Inj proc ankle arthr CPT 27648 | $18.13 | $259.00 | $42.86 – $327.46 | 34 |
| Inj proc elbow arthro CPT 24220 | $187.67 | $2,681.00 | $55.69 – $358.31 | 36 |
| Inj proc for lymphang CPT 38790 | $19.74 | $282.00 | $20.00 – $175.97 | 34 |
| Inj proc lumbr disk ea lvl CPT 62290 | $37.45 | $535.00 | $143.72 – $563.26 | 27 |
| Inj proc myelogram lumbar CPT 62284 | $19.74 | $282.00 | $71.76 – $303.29 | 34 |
| Inj proc sialogram CPT 42550 | $172.41 | $2,463.00 | $51.64 – $208.00 | 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.