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 |
|---|---|---|---|---|
| Angio trnslmnl balloon same vein ini CPT 37248 | $2,034.76 | $29,068.00 | $85.00 – $15,013.92 | 36 |
| Ankle arthroscopy/surgery CPT 29891 | $165.97 | $2,371.00 | $235.00 – $8,631.30 | 36 |
| Ankle arthroscopy/surgery CPT 29894 | $124.32 | $1,776.00 | $421.82 – $1,032.21 | 34 |
| Ankle arthroscopy/surgery CPT 29895 | $113.12 | $1,616.00 | $161.00 – $1,010.86 | 34 |
| Ankle arthroscopy/surgery CPT 29897 | $121.03 | $1,729.00 | $375.28 – $1,060.69 | 34 |
| Ankle arthroscopy/surgery CPT 29898 | $137.48 | $1,964.00 | $415.86 – $1,179.33 | 34 |
| Ankle X-ray CPT 73610 | $147.84 | $2,112.00 | $8.52 – $229.57 | 37 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | $22.82 | $326.00 | $15.00 – $304.00 | 36 |
| Annual alcohol screen 15 min HCPCS G0442 | $3.15 | $45.00 | $1.24 – $98.84 | 34 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $18.55 | $265.00 | $90.05 – $304.00 | 27 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $18.55 | $265.00 | $101.29 – $312.00 | 27 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $23.03 | $329.00 | $101.29 – $304.00 | 27 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $23.03 | $329.00 | $124.34 – $374.40 | 27 |
| Anora (draw only) CPT 99001 | $2.31 | $33.00 | $2.79 – $95.14 | 16 |
| Anoscopy CPT 46611 | $19.25 | $275.00 | $74.91 – $2,453.16 | 36 |
| Anoscopy ablation lesion 46615 CPT 46615 | $21.70 | $310.00 | $84.10 – $282.14 | 34 |
| Anoscopy and biopsy CPT 46606 | $68.95 | $985.00 | $29.04 – $368.29 | 36 |
| Anoscopy and dilation 46604 CPT 46604 | $157.29 | $2,247.00 | $30.00 – $1,038.40 | 36 |
| Anoscopy remove fb 46608 CPT 46608 | $19.95 | $285.00 | $30.00 – $386.30 | 34 |
| Anoscopy remove lesion 46610 CPT 46610 | $19.18 | $274.00 | $75.86 – $7,321.98 | 36 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | $22.47 | $321.00 | $10.00 – $446.59 | 34 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | $147.35 | $2,105.00 | $248.00 – $1,273.45 | 34 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $5.74 | $82.00 | $4.74 – $141.69 | 23 |
| Antibody elution rbc reference CPT 86860 | $5.25 | $75.00 | $9.01 – $449.42 | 23 |
| Antibody htlv/hiv confirm test CPT 86689 | $1.35 | $19.35 | $7.19 – $212.83 | 23 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $25.34 | $362.00 | $5.70 – $171.37 | 23 |
| Antibody id rbc panel CPT 86870 | $62.37 | $891.00 | $7.50 – $945.55 | 23 |
| Antibody influenza virus CPT 86710 | $3.78 | $54.00 | $4.98 – $136.71 | 36 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $0.80 | $11.44 | $4.72 – $141.54 | 23 |
| Antibody screen rbc CPT 86850 | $46.62 | $666.00 | $3.61 – $118.74 | 23 |
| Anticoag mgmt pt warfarin CPT 93793 | $1.96 | $28.00 | $12.15 – $24.30 | 18 |
| Antidepressant not specified CPT 80338 | $4.55 | $65.00 | $0.03 – $180.77 | 8 |
| Antidepressants class 6/more CPT 80334 | $0.35 | $5.00 | $0.03 – $216.90 | 8 |
| Antiepileptics nos 7/more CPT 80341 | $0.28 | $4.00 | $0.03 – $167.82 | 8 |
| Antigen therapy services CPT 95145 | $6.44 | $92.00 | $2.58 – $123.52 | 36 |
| Antigen therapy services CPT 95146 | $11.90 | $170.00 | $2.58 – $204.00 | 34 |
| Antigen therapy services CPT 95148 | $17.01 | $243.00 | $2.58 – $189.93 | 36 |
| Antigen therapy services CPT 95165 | $2.59 | $37.00 | $2.58 – $123.52 | 36 |
| Antigen therapy services CPT 95170 | $1.89 | $27.00 | $11.83 – $304.00 | 18 |
| Anti mog serum - sendout CPT 86362 | $12.25 | $175.00 | $12.05 – $35.68 | 22 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $0.84 | $12.05 | $12.05 – $35.68 | 22 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | $165.20 | $2,360.00 | $71.85 – $1,547.13 | 34 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | $171.92 | $2,456.00 | $334.00 – $1,606.45 | 34 |
| Antinuclear antibodies CPT 86038 | $10.78 | $154.00 | $3.92 – $132.88 | 23 |
| Antinuclear antibodies titer CPT 86039 | $10.57 | $151.00 | $3.92 – $122.59 | 23 |
| Antiphosphatidylserine antibody CPT 86148 | $2.17 | $31.00 | $5.93 – $177.66 | 23 |
| Antipsychotics nos 1-3 CPT 80342 | $11.97 | $171.00 | $0.03 – $157.31 | 8 |
| Antipsychotics nos 7/more CPT 80344 | $0.28 | $4.00 | $0.03 – $188.77 | 8 |
| Antistreptolysin o titer CPT 86060 | $0.51 | $7.30 | $2.51 – $80.25 | 23 |
| Antithrombin iii activity CPT 85300 | $2.66 | $38.00 | $4.23 – $130.29 | 23 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | $207.41 | $2,963.00 | $60.00 – $1,825.98 | 34 |
| Aortic dysfunction/dilation CPT 81410 | $44.52 | $636.00 | $504.00 – $22,668.84 | 22 |
| Aortic dysfunction/dilation CPT 81411 | $119.28 | $1,704.00 | $1,350.19 – $22,668.84 | 22 |
| Apl(pml-rara) quant - sendout CPT 81315 | $14.51 | $207.31 | $129.48 – $562.09 | 23 |
| Appendectomy CPT 44950 | $150.71 | $2,153.00 | $65.00 – $1,119.06 | 34 |
| Appendectomy add-on 44955 CPT 44955 | $19.18 | $274.00 | $71.34 – $156.48 | 27 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | $205.24 | $2,932.00 | $101.27 – $1,486.55 | 34 |
| Appendix Removal (Laparoscopic) CPT 44970 | $142.73 | $2,039.00 | $155.00 – $1,183.92 | 34 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $287.14 | $4,102.00 | $40.00 – $5,442.78 | 36 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $287.14 | $4,102.00 | $45.42 – $132.67 | 36 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $327.11 | $4,673.00 | $20.48 – $54.15 | 36 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $916.30 | $13,090.00 | $167.57 – $5,442.78 | 36 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $358.96 | $5,128.00 | $36.64 – $113.72 | 36 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $205.87 | $2,941.00 | $14.31 – $55.00 | 36 |
| Appl body cast sho to hips CPT 29035 | $68.46 | $978.00 | $152.00 – $483.85 | 18 |
| Appl cast figure-of-eight CPT 29049 | $25.76 | $368.00 | $121.00 – $304.00 | 18 |
| Application clubfoot cast CPT 29450 | $35.98 | $514.00 | $68.50 – $304.00 | 36 |
| Application finger splntstatic 29130 CPT 29130 | $29.75 | $425.00 | $22.34 – $304.00 | 36 |
| Application long leg splint 29505 CPT 29505 | $23.52 | $336.00 | $31.00 – $304.00 | 36 |
| Application lower leg splint 29515 CPT 29515 | $18.62 | $266.00 | $50.43 – $304.00 | 36 |
| Application multi layer compression below knee (both sides) CPT 29581 | $65.94 | $942.00 | $15.03 – $304.00 | 36 |
| Application of cylinder cast 29365 CPT 29365 | $31.71 | $453.00 | $33.00 – $304.00 | 36 |
| Application of forearm cast 29075 CPT 29075 | $30.87 | $441.00 | $35.00 – $304.00 | 36 |
| Application of long arm cast 29065 CPT 29065 | $30.87 | $441.00 | $11.00 – $304.00 | 36 |
| Application of long leg cast CPT 29355 | $35.77 | $511.00 | $96.99 – $304.00 | 36 |
| Application of long leg cast 29345 CPT 29345 | $34.37 | $491.00 | $39.00 – $304.00 | 36 |
| Application of paste boot 29580 CPT 29580 | $47.46 | $678.00 | $22.89 – $304.00 | 36 |
| Application short leg cast 29405 CPT 29405 | $30.87 | $441.00 | $56.64 – $304.00 | 36 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $412.65 | $5,895.00 | $20.00 – $1,949.62 | 36 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $358.96 | $5,128.00 | $25.00 – $304.00 | 36 |
| Appl long leg cast brace CPT 29358 | $41.72 | $596.00 | $152.00 – $312.19 | 18 |
| Appl mltpln uni ext fixj sys CPT 20692 | $276.01 | $3,943.00 | $30.00 – $1,531.29 | 34 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $9.87 | $141.00 | $6.24 – $499.00 | 25 |
| Appl multlay comprs arm/hand CPT 29584 | $3.78 | $54.00 | $12.83 – $428.66 | 36 |
| Appl patllr tdn bearing cast CPT 29435 | $21.14 | $302.00 | $81.43 – $737.81 | 36 |
| Appl unipln uni ext fixj sys CPT 20690 | $144.97 | $2,071.00 | $30.00 – $798.71 | 36 |
| Apply forearm splintdynamic 29126 CPT 29126 | $37.87 | $541.00 | $64.41 – $435.00 | 22 |
| Apply hand/wrist cast 29085 CPT 29085 | $24.85 | $355.00 | $11.00 – $304.00 | 36 |
| Apply of finger splint 29131 CPT 29131 | $13.93 | $199.00 | $33.51 – $304.00 | 18 |
| Apply rem fixation device CPT 20660 | $54.95 | $785.00 | $60.00 – $469.83 | 34 |
| Apply rigid leg cast 29445 CPT 29445 | $100.03 | $1,429.00 | $43.00 – $304.00 | 36 |
| Apply r&l pulm art bands CPT 33620 | $371.77 | $5,311.00 | $90.00 – $4,461.21 | 34 |
| Apply short leg castambul type 29425 CPT 29425 | $19.32 | $276.00 | $13.00 – $304.00 | 36 |
| App topical fluoride varnish CPT 99188 | $3.08 | $44.00 | $39.00 – $304.00 | 17 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $7.98 | $114.00 | $1.64 – $132.24 | 18 |
| Aquaporin-4 antibody cba each CPT 86052 | $21.00 | $300.00 | $12.05 – $35.68 | 22 |
| Aquaporin-4 antibody elisa CPT 86051 | $0.81 | $11.53 | $11.53 – $34.13 | 22 |
| Aquatic exercise - group charge CPT 97150 | $25.27 | $361.00 | $18.64 – $499.00 | 25 |
| Art byp aor celiac msn and renal 35631 CPT 35631 | $408.87 | $5,841.00 | $238.27 – $3,518.64 | 34 |
| Art byp aortofemoral 35647 CPT 35647 | $340.41 | $4,863.00 | $50.00 – $2,923.81 | 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.