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 |
|---|---|---|---|---|
| Mast rad urban type CPT 19306 | $289.66 | $4,138.00 | $65.00 – $2,244.23 | 34 |
| Mast simple complete CPT 19303 | $226.59 | $3,237.00 | $75.00 – $1,775.26 | 34 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $9.94 | $142.00 | $11.57 – $278.94 | 34 |
| M.avium-intra dna dir prob CPT 87560 | $1.91 | $27.29 | $7.45 – $213.35 | 23 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $1.01 | $14.46 | $5.33 – $158.94 | 23 |
| Mayo aathr protein s free CPT 85306 | $1.07 | $15.32 | $5.66 – $168.56 | 23 |
| Mayo activated protein c resistance assay CPT 85307 | $1.07 | $15.32 | $3.75 – $168.41 | 23 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $14.74 | $210.50 | $38.57 – $143.91 | 23 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $6.76 | $96.59 | $0.03 – $109.12 | 8 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $38.71 | $553.00 | $0.03 – $109.12 | 8 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $1.25 | $17.80 | $5.45 – $162.64 | 23 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $9.52 | $136.00 | $0.03 – $303.14 | 8 |
| Mayo alpha 1 antitrypsin CPT 82103 | $2.55 | $36.36 | $4.92 – $147.61 | 23 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $1.06 | $15.08 | $3.90 – $165.75 | 23 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $0.60 | $8.59 | $0.03 – $172.63 | 8 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $0.60 | $8.59 | $0.03 – $156.94 | 8 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $7.57 | $108.11 | $108.11 – $1,360.17 | 23 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $22.75 | $325.00 | $91.30 – $509.16 | 23 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $9.59 | $137.00 | $109.60 – $896.54 | 23 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $101.33 | $1,447.50 | $111.73 – $2,320.00 | 22 |
| Mayo androstenedione CPT 82157 | $2.05 | $29.28 | $10.96 – $321.80 | 23 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $1.02 | $14.60 | $5.38 – $160.49 | 23 |
| Mayo antithrombin iii antigen CPT 85301 | $0.76 | $10.81 | $3.94 – $118.89 | 23 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $1.05 | $15.05 | $5.55 – $165.52 | 23 |
| Mayo avwpr vw factor activity CPT 85397 | $6.65 | $95.00 | $30.86 – $240.88 | 23 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $2.11 | $30.15 | $30.15 – $233.26 | 22 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $10.64 | $152.00 | $0.03 – $115.63 | 8 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $0.71 | $10.18 | $2.49 – $111.78 | 23 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $10.14 | $144.84 | $35.00 – $425.21 | 23 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $19.25 | $275.00 | $51.00 – $1,232.03 | 23 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $0.90 | $12.90 | $4.74 – $145.02 | 23 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $1.76 | $25.17 | $0.03 – $186.77 | 8 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $0.92 | $13.19 | $4.85 – $145.02 | 23 |
| Mayo brcmg brucella antibody igm CPT 86622 | $0.63 | $8.93 | $3.18 – $88.68 | 23 |
| Mayo c1 esterase inhibitor CPT 83883 | $4.32 | $61.76 | $5.00 – $149.68 | 23 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $22.19 | $317.00 | $0.03 – $239.18 | 8 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $1.18 | $16.87 | $6.25 – $184.62 | 23 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $2.89 | $41.33 | $6.55 – $294.41 | 23 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $7.60 | $108.64 | $108.64 – $796.16 | 23 |
| Mayo ceruloplasmin CPT 82390 | $0.75 | $10.74 | $3.91 – $118.07 | 23 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $5.92 | $84.50 | $5.21 – $155.38 | 23 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $9.01 | $128.75 | $4.74 – $141.69 | 23 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $3.92 | $56.00 | $4.32 – $141.91 | 23 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $1.70 | $24.34 | $4.65 – $141.91 | 23 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $27.30 | $390.00 | $97.50 – $1,087.53 | 24 |
| Mayo chromium CPT 82495 | $6.93 | $99.00 | $7.55 – $222.97 | 23 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $13.86 | $198.00 | $0.03 – $153.09 | 8 |
| Mayo coccidioides antibody CPT 86635 | $0.80 | $11.47 | $4.19 – $127.92 | 23 |
| Mayo cocou cortisone urine CPT 82542 | $36.40 | $520.00 | $6.71 – $197.73 | 23 |
| Mayo cortisol free CPT 82530 | $1.17 | $16.71 | $6.18 – $186.47 | 23 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $5.81 | $83.00 | $27.50 – $311.88 | 23 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $0.85 | $12.12 | $4.43 – $138.80 | 23 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $1.80 | $25.68 | $0.03 – $205.42 | 8 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $1.89 | $27.00 | $0.03 – $235.78 | 8 |
| Mayo cyanide CPT 82600 | $3.78 | $54.00 | $7.22 – $213.35 | 23 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $31.29 | $447.00 | $206.64 – $3,064.87 | 24 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $0.93 | $13.25 | $4.87 – $145.69 | 23 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $1.77 | $25.27 | $9.45 – $277.90 | 23 |
| Mayo dihydrotestosterone CPT 82642 | $1.82 | $26.02 | $26.02 – $212.90 | 23 |
| Mayo efpo chloride stool CPT 82438 | $0.61 | $8.73 | $1.46 – $53.74 | 23 |
| Mayo estriol CPT 82677 | $1.69 | $24.18 | $9.03 – $267.02 | 23 |
| Mayo estrone CPT 82679 | $1.75 | $24.95 | $9.32 – $274.42 | 23 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $1.02 | $14.52 | $6.05 – $179.66 | 23 |
| Mayo everolimus therapeutic drug level CPT 80169 | $0.85 | $12.21 | $12.21 – $86.91 | 23 |
| Mayo factor ii CPT 85210 | $0.91 | $12.98 | $4.45 – $142.80 | 23 |
| Mayo factor v CPT 85220 | $1.24 | $17.65 | $6.54 – $194.10 | 23 |
| Mayo factor vii CPT 85230 | $1.25 | $17.90 | $6.64 – $196.91 | 23 |
| Mayo factor viii vw factor antigen CPT 85246 | $5.91 | $84.41 | $8.56 – $252.28 | 23 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $5.91 | $84.41 | $8.56 – $252.28 | 23 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $5.91 | $84.41 | $8.56 – $252.28 | 23 |
| Mayo factor x CPT 85260 | $1.25 | $17.90 | $6.64 – $196.91 | 23 |
| Mayo factor xi CPT 85270 | $1.25 | $17.90 | $6.64 – $196.91 | 23 |
| Mayo fat/lipids feces quantitative CPT 82710 | $1.18 | $16.80 | $6.39 – $184.77 | 23 |
| Mayo fbl culture fungi blood CPT 87103 | $62.58 | $894.00 | $3.26 – $99.12 | 23 |
| Mayo fdp/fsp paracoagulation CPT 85366 | $5.63 | $80.46 | $2.35 – $160.92 | 23 |
| Mayo ffspg allergen clam igg CPT 86001 | $1.24 | $17.75 | $1.57 – $57.45 | 23 |
| Mayo fibrinogen antigen CPT 85385 | $0.65 | $9.25 | $3.04 – $92.83 | 23 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $1.52 | $21.67 | $14.43 – $83.95 | 23 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $123.90 | $1,770.00 | $14.00 – $141.66 | 7 |
| Mayo hemosiderin qualitative urine CPT 83070 | $0.33 | $4.75 | $1.64 – $52.19 | 23 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $6.30 | $90.00 | $12.31 – $373.39 | 23 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $3.15 | $45.00 | $12.31 – $373.39 | 23 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $0.78 | $11.11 | $4.59 – $138.80 | 23 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $1.81 | $25.81 | $9.65 – $261.24 | 23 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $1.30 | $18.60 | $3.21 – $97.64 | 23 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $1.94 | $27.77 | $3.48 – $151.02 | 23 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $12.95 | $185.00 | $10.16 – $298.70 | 23 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $18.20 | $260.00 | $4.75 – $142.35 | 23 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $18.76 | $268.00 | $4.60 – $164.86 | 23 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $34.37 | $491.00 | $5.09 – $228.67 | 23 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $11.55 | $165.00 | $7.75 – $228.82 | 23 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $25.62 | $366.00 | $3.18 – $98.83 | 23 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $2.00 | $28.52 | $2.38 – $99.94 | 23 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $2.46 | $35.09 | $8.59 – $377.54 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $7.57 | $108.15 | $35.09 – $130.95 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $2.46 | $35.09 | $12.31 – $373.39 | 23 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $33.04 | $472.00 | $35.09 – $82.86 | 22 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $3.00 | $42.84 | $16.12 – $284.49 | 23 |
| Mayo infliximab therapeutic drug level CPT 80230 | $15.12 | $216.00 | $30.86 – $143.91 | 23 |
| Mayo inhab inhibin a CPT 86336 | $1.09 | $15.59 | $3.81 – $248.73 | 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.