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 |
|---|---|---|---|---|
| Microalbumin urine screen CPT 82044 | $1.75 | $25.00 | $1.56 – $10.30 | 33 |
| Microbe susceptible mlc CPT 87187 | $2.81 | $40.17 | $3.77 – $96.98 | 23 |
| Microdissection manual CPT 88381 | $7.90 | $112.83 | $112.83 – $1,329.75 | 24 |
| Microsatellite instability CPT 81301 | $32.55 | $465.00 | $348.56 – $1,740.45 | 23 |
| Microsurg tehniq require use oper micro (add-on)69990 CPT 69990 | $48.72 | $696.00 | $15.00 – $385.04 | 35 |
| Microvolt t-wave assess CPT 93025 | $10.43 | $149.00 | $38.70 – $2,420.92 | 37 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $12.41 | $177.30 | $0.32 – $124.04 | 11 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $55.42 | $791.74 | $0.22 – $1,131.40 | 10 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $33.58 | $479.71 | $3.04 – $685.51 | 11 |
| Misoprostol, oral, 200 mcg HCPCS S0191 | $2.14 | $30.58 | $0.99 – $43.69 | 9 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $483.00 | $6,900.00 | $20.35 – $277.32 | 31 |
| Mitral valve replacement w/bypass 33430 CPT 33430 | $595.63 | $8,509.00 | $145.00 – $4,792.94 | 34 |
| Mnl appl strs jt radiography CPT 77071 | $15.54 | $222.00 | $24.56 – $229.57 | 37 |
| Mnl prep&insj dp rx dlvr dev CPT 20700 | $19.60 | $280.00 | $68.89 – $180.34 | 34 |
| Mnl prep&insj i-artic rx dev CPT 20704 | $35.14 | $502.00 | $45.00 – $310.85 | 34 |
| Mnpj anes sho jt fixj aprats CPT 23700 | $48.44 | $692.00 | $38.00 – $4,241.76 | 36 |
| Mnpj elbow under anes CPT 24300 | $113.54 | $1,622.00 | $60.31 – $761.70 | 34 |
| Mobilization of colon 44139 CPT 44139 | $27.51 | $393.00 | $46.00 – $222.86 | 34 |
| Mometasone sinus sinuva HCPCS J7402 | $883.75 | $12,625.00 | $5.69 – $30.90 | 23 |
| Mopath procedure level 1 CPT 81400 | $28.35 | $405.00 | $63.96 – $333.12 | 23 |
| Mopath procedure level 3 CPT 81402 | $32.41 | $463.00 | $150.33 – $783.06 | 23 |
| Mopath procedure level 5 CPT 81404 | $116.20 | $1,660.00 | $75.00 – $1,892.65 | 23 |
| Mopath procedure level 6 CPT 81405 | $54.18 | $774.00 | $41.40 – $2,481.09 | 23 |
| Mopath procedure level 7 CPT 81406 | $63.00 | $900.00 | $38.00 – $2,530.84 | 23 |
| Mopath procedure level 8 CPT 81407 | $59.24 | $846.27 | $112.00 – $20,401.99 | 23 |
| Mopath procedure level 9 CPT 81408 | $136.01 | $1,943.00 | $442.00 – $23,842.62 | 23 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $12.10 | $172.91 | $0.36 – $9.60 | 19 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $38.76 | $553.68 | $6.53 – $791.21 | 11 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | $21.00 | $300.00 | $53.50 – $1,640.88 | 24 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $19.95 | $285.00 | $28.58 – $449.42 | 36 |
| Motor &/ sens nrve cndj test CPT 95905 | $11.55 | $165.00 | $2.61 – $1,178.42 | 37 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | $70.91 | $1,013.00 | $237.16 – $8,745.94 | 36 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $33.60 | $480.00 | $76.70 – $1,526.73 | 24 |
| M/phmtrc alysishquant/semiq CPT 88369 | $14.00 | $200.00 | $29.03 – $499.16 | 24 |
| Mpl gene analysis common variants CPT 81338 | $10.52 | $150.33 | $120.26 – $560.90 | 23 |
| Mpsv4 vaccine subq CPT 90733 | $23.94 | $342.00 | $12.00 – $152.23 | 14 |
| MRA abdomen post contrast CPT 74185 | $920.08 | $13,144.00 | $46.75 – $3,139.72 | 37 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $23.24 | $332.00 | $46.83 – $406.36 | 34 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $23.87 | $341.00 | $47.12 – $406.36 | 34 |
| MRA pelvis CPT 72198 | $23.24 | $332.00 | $46.75 – $406.36 | 34 |
| MRA pelvis w IV cont HCPCS C8918 | $267.89 | $3,827.00 | $460.15 – $5,468.78 | 22 |
| MRA upper extremity post contrast-bil CPT 73225 | $21.91 | $313.00 | $44.89 – $406.36 | 34 |
| MRA w/cont, lwr ext HCPCS C8912 | $267.89 | $3,827.00 | $460.15 – $5,468.78 | 22 |
| MRI breast c- unilateral CPT 77046 | $18.76 | $268.00 | $37.78 – $406.36 | 34 |
| MRI breast c-+ w/cad uni CPT 77048 | $170.66 | $2,438.00 | $54.62 – $2,709.07 | 36 |
| MRI breast without cont bi CPT 77047 | $20.79 | $297.00 | $41.81 – $406.36 | 34 |
| MRI breast w IV cont bi CPT 77049 | $321.86 | $4,598.00 | $59.76 – $2,695.61 | 36 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $30.31 | $433.00 | $60.65 – $519.60 | 34 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $33.60 | $480.00 | $67.10 – $433.24 | 34 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $38.43 | $549.00 | $76.96 – $658.80 | 34 |
| MRI chest without contrast CPT 71550 | $875.77 | $12,511.00 | $38.16 – $3,135.73 | 37 |
| MRI chest without & w/contrast CPT 71552 | $1,015.42 | $14,506.00 | $59.21 – $7,041.89 | 37 |
| MRI chest w IV cont CPT 71551 | $890.40 | $12,720.00 | $45.28 – $3,829.21 | 37 |
| MRI guid ndl plc s&i CPT 77021 | $19.46 | $278.00 | $71.90 – $406.36 | 33 |
| MRI loex nonjt w IV cont CPT 73719 | $658.00 | $9,400.00 | $42.56 – $3,820.49 | 37 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $945.28 | $13,504.00 | $35.36 – $3,186.49 | 37 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $686.00 | $9,800.00 | $56.31 – $3,134.13 | 37 |
| MRI orbit/face/neck without contrast CPT 70540 | $784.98 | $11,214.00 | $35.17 – $3,134.13 | 37 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $949.41 | $13,563.00 | $56.12 – $7,072.14 | 37 |
| MRI orbit fac&nck w IV cont CPT 70542 | $21.07 | $301.00 | $42.56 – $406.36 | 34 |
| MRI tmj CPT 70336 | $19.11 | $273.00 | $38.53 – $406.36 | 34 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $700.49 | $10,007.00 | $35.56 – $3,186.49 | 37 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $727.16 | $10,388.00 | $56.31 – $3,134.13 | 37 |
| MRI upper extremity w/dye CPT 73219 | $31.64 | $452.00 | $42.56 – $406.36 | 34 |
| Msh2 gene known variants CPT 81296 | $23.64 | $337.73 | $103.48 – $675.46 | 23 |
| Msh6 gene known variants CPT 81299 | $21.56 | $308.00 | $103.48 – $616.00 | 23 |
| Mthfr gene analy common variants CPT 81291 | $4.57 | $65.34 | $65.34 – $481.32 | 22 |
| M.tuberculo dna dir probe CPT 87555 | $1.88 | $26.88 | $7.45 – $213.35 | 23 |
| Mucopolysaccharides CPT 83864 | $10.52 | $150.25 | $4.39 – $211.79 | 23 |
| Multi family grp psychotherapy CPT 90849 | $6.86 | $98.00 | $30.80 – $67.71 | 34 |
| Multiple sleep latency test CPT 95805 | $265.16 | $3,788.00 | $59.31 – $2,265.30 | 37 |
| Mumps antibody igg CPT 86735 | $18.41 | $263.00 | $4.79 – $145.02 | 23 |
| Muscle-skin graft arm CPT 15736 | $294.00 | $4,200.00 | $867.46 – $2,198.57 | 34 |
| Muscle-skin graft leg CPT 15738 | $302.82 | $4,326.00 | $60.00 – $2,323.12 | 34 |
| Muscle-skin graft trunk CPT 15734 | $536.06 | $7,658.00 | $817.00 – $9,348.08 | 36 |
| Muscle test cran nerv unilat CPT 95867 | $18.76 | $268.00 | $42.43 – $569.59 | 37 |
| Muscle test hemidiaphragm CPT 95866 | $23.38 | $334.00 | $61.35 – $108.18 | 34 |
| Muscle test larynx CPT 95865 | $26.11 | $373.00 | $59.24 – $138.12 | 34 |
| Muscle test one fiber CPT 95872 | $32.13 | $459.00 | $53.97 – $230.45 | 34 |
| Muscle transfer shoulder/arm CPT 23395 | $311.36 | $4,448.00 | $944.53 – $2,541.38 | 34 |
| Musc myoq/fscq flp h&n pedcl CPT 15733 | $248.15 | $3,545.00 | $65.00 – $2,125.47 | 34 |
| Musc/tdn transfer upr a/e 1 CPT 24301 | $183.96 | $2,628.00 | $60.00 – $1,490.18 | 34 |
| Mycobacteria dna amp probe CPT 87551 | $21.41 | $305.89 | $12.31 – $373.39 | 23 |
| Mycobacteria dna dir probe CPT 87550 | $1.40 | $20.05 | $7.45 – $213.35 | 23 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $1.74 | $24.84 | $0.25 – $19.97 | 10 |
| Mycophenolic acid HCPCS J7518 | $3.96 | $56.50 | $0.72 – $80.74 | 10 |
| Mycoplasma antibody igm CPT 86738 | $6.16 | $88.00 | $4.85 – $145.02 | 23 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $21.00 | $300.00 | $140.32 – $1,147.79 | 23 |
| Myelography l-s spine CPT 72265 | $10.99 | $157.00 | $40.86 – $2,067.92 | 37 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $390.25 | $5,575.00 | $18.00 – $2,067.92 | 36 |
| Myelography via inj w/s&i cervical CPT 62302 | $415.03 | $5,929.00 | $18.00 – $2,067.92 | 36 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $611.38 | $8,734.00 | $100.66 – $2,067.92 | 30 |
| Myelography via inj w/s&i thoracic CPT 62303 | $28.28 | $404.00 | $38.00 – $904.87 | 34 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $20.04 | $286.25 | $3.18 – $257.24 | 23 |
| Myomectomy abdom complex CPT 58146 | $273.28 | $3,904.00 | $60.00 – $2,441.66 | 34 |
| Myomectomy abdom method CPT 58140 | $218.96 | $3,128.00 | $425.00 – $1,912.81 | 34 |
| Myomectomy vag method CPT 58145 | $134.89 | $1,927.00 | $74.48 – $1,131.37 | 36 |
| Myringoplasty CPT 69620 | $185.15 | $2,645.00 | $152.00 – $1,105.34 | 36 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $50.60 | $722.83 | $0.11 – $532.32 | 10 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $17.93 | $256.20 | $3.45 – $25.20 | 19 |
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.