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 |
|---|---|---|---|---|
| Optx scapular fx w/int fixj CPT 23585 | $236.88 | $3,384.00 | $101.27 – $1,362.04 | 34 |
| Optx sho dislc fx CPT 23670 | $213.43 | $3,049.00 | $101.27 – $1,205.43 | 34 |
| Optx sho dislc neck fx fixj CPT 23680 | $226.94 | $3,242.00 | $35.00 – $1,499.67 | 34 |
| Optx thigh fx CPT 27269 | $297.85 | $4,255.00 | $65.00 – $2,384.76 | 34 |
| Optx trns-scphprlnr fx dislc CPT 25685 | $180.60 | $2,580.00 | $70.00 – $1,440.35 | 34 |
| Optx ulnar shft fx int fixj CPT 25545 | $155.82 | $2,226.00 | $259.00 – $1,359.67 | 34 |
| Optx ulnar styloid fracture CPT 25652 | $155.47 | $2,221.00 | $35.00 – $1,200.69 | 34 |
| Oral aprepitant HCPCS J8501 | $63.88 | $912.50 | $2.97 – $1,303.96 | 10 |
| Orchiectomy partial CPT 54522 | $141.82 | $2,026.00 | $102.75 – $1,023.26 | 34 |
| Orchiopexy (fowler-stephens) CPT 54650 | $171.85 | $2,455.00 | $104.24 – $1,231.07 | 34 |
| Orchiopexy ingun/scrot appr CPT 54640 | $104.09 | $1,487.00 | $60.00 – $9,444.82 | 36 |
| Organic acids total quant ea spec CPT 83918 | $6.87 | $98.20 | $6.09 – $175.15 | 23 |
| Oropharyngeal biopsy 42800 CPT 42800 | $39.34 | $562.00 | $49.00 – $304.00 | 36 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $1.82 | $26.00 | $2.76 – $30.16 | 19 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $54.11 | $773.00 | $141.11 – $896.68 | 32 |
| Ortho elbow w/lock w/ft&adj HCPCS L3760 | $93.66 | $1,338.00 | $244.39 – $1,552.08 | 34 |
| Ortho ewh rgd without jnt cstm w/fit&adj HCPCS L3763 | $379.75 | $5,425.00 | $920.62 – $1,841.24 | 17 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $52.92 | $756.00 | $213.37 – $591.32 | 17 |
| Orthovisc inj per dose HCPCS J7324 | $35.56 | $508.00 | $92.67 – $396.72 | 31 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $85.19 | $1,217.00 | $168.41 – $1,411.72 | 32 |
| Osmolality blood CPT 83930 | $50.89 | $727.00 | $2.09 – $98.97 | 23 |
| Osmolality urine CPT 83935 | $50.96 | $728.00 | $2.09 – $74.99 | 23 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | $78.68 | $1,124.00 | $307.76 – $883.99 | 34 |
| Ostectomy scapula partial CPT 23190 | $142.59 | $2,037.00 | $59.20 – $1,093.91 | 34 |
| Osteochondral knee allograft CPT 27415 | $331.87 | $4,741.00 | $469.00 – $2,754.94 | 34 |
| Osteochondral knee autograft CPT 27416 | $238.07 | $3,401.00 | $741.62 – $1,867.47 | 34 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $10.36 | $148.00 | $28.48 – $135.60 | 36 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | $12.60 | $180.00 | $28.48 – $171.60 | 36 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | $14.77 | $211.00 | $28.48 – $204.00 | 36 |
| Osteot dsc ant 1 vrt sgm crv CPT 22220 | $386.47 | $5,521.00 | $1,065.15 – $3,117.99 | 34 |
| Osteot dsc ant 1vrt sgm ea CPT 22226 | $82.60 | $1,180.00 | $61.06 – $766.45 | 34 |
| Osteot dsc ant 1vrt sgm lmbr CPT 22224 | $379.05 | $5,415.00 | $202.90 – $3,091.89 | 34 |
| Osteot dsc ant 1vrt sgm thrc CPT 22222 | $414.05 | $5,915.00 | $65.00 – $2,892.57 | 34 |
| Ot evaluation high complexity patient/family CPT 97167 | $83.30 | $1,190.00 | $105.94 – $499.00 | 25 |
| Ot evaluation low complexity patient/family CPT 97165 | $48.16 | $688.00 | $105.94 – $983.15 | 24 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $62.51 | $893.00 | $105.94 – $1,276.10 | 24 |
| Oth resp proc, group HCPCS G0239 | $12.53 | $179.00 | $49.26 – $499.00 | 23 |
| Oth resp proc, indiv HCPCS G0238 | $12.53 | $179.00 | $38.15 – $499.00 | 23 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $22.61 | $323.00 | $53.46 – $499.00 | 24 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $26.60 | $380.00 | $32.06 – $445.00 | 37 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $18.20 | $260.00 | $22.21 – $445.00 | 37 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $5.18 | $74.00 | $7.76 – $48.24 | 36 |
| Otoplasty 69300 CPT 69300 | $115.78 | $1,654.00 | $74.46 – $8,745.94 | 36 |
| Ot re-evaluation patient/family CPT 97168 | $30.45 | $435.00 | $72.32 – $499.00 | 25 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $26.11 | $373.00 | $15.98 – $499.00 | 25 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $18.20 | $260.00 | $18.87 – $499.00 | 25 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $18.20 | $260.00 | $20.09 – $499.00 | 25 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $23.73 | $339.00 | $10.96 – $445.00 | 37 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $23.87 | $341.00 | $12.22 – $445.00 | 37 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $23.38 | $334.00 | $5.31 – $445.00 | 37 |
| Ovarian cystectomy 58925 CPT 58925 | $183.54 | $2,622.00 | $33.00 – $1,515.51 | 34 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $8.63 | $123.29 | $0.51 – $76.21 | 11 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $223.16 | $3,188.00 | $54.00 – $2,252.63 | 29 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | $365.19 | $5,217.00 | $50.00 – $2,690.97 | 34 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $10.83 | $154.74 | $2.54 – $221.12 | 10 |
| Papaverin hcl injection HCPCS J2440 | $72.53 | $1,036.08 | $0.76 – $104.40 | 19 |
| Parathormone (pth) intact CPT 83970 | $34.30 | $490.00 | $15.53 – $453.86 | 23 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | $335.58 | $4,794.00 | $70.00 – $2,934.33 | 34 |
| Parathyroid planar imaging CPT 78070 | $340.55 | $4,865.00 | $37.10 – $1,054.57 | 37 |
| Parathyroid planar img w/tomo spect CPT 78071 | $15.26 | $218.00 | $55.09 – $422.03 | 34 |
| Parial mast w/lymph removal 19302 CPT 19302 | $214.55 | $3,065.00 | $358.00 – $1,745.52 | 34 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $43.61 | $623.00 | $7.00 – $304.00 | 36 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | $214.48 | $3,064.00 | $99.40 – $1,554.25 | 34 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | $49.35 | $705.00 | $55.00 – $384.14 | 36 |
| Partial complicated cystectomy 51555 CPT 51555 | $299.74 | $4,282.00 | $80.00 – $2,164.90 | 34 |
| Partial exc bone humerus CPT 24140 | $173.11 | $2,473.00 | $411.02 – $1,475.94 | 34 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | $108.92 | $1,556.00 | $35.00 – $8,631.30 | 36 |
| Partial excision of lip CPT 40500 | $92.26 | $1,318.00 | $50.00 – $8,745.94 | 36 |
| Partial hip replacement CPT 27125 | $273.35 | $3,905.00 | $95.00 – $2,216.29 | 34 |
| Partial hysterectomy CPT 58180 | $228.76 | $3,268.00 | $384.00 – $1,983.85 | 34 |
| Partial proctectomy; perineal 45123 CPT 45123 | $263.90 | $3,770.00 | $865.60 – $1,910.61 | 34 |
| Partial removal finger bone CPT 26235 | $123.20 | $1,760.00 | $56.96 – $965.77 | 34 |
| Partial removal finger bone CPT 26236 | $111.02 | $1,586.00 | $20.00 – $4,241.76 | 36 |
| Partial removal foot fascia CPT 28060 | $89.32 | $1,276.00 | $45.00 – $854.35 | 34 |
| Partial removal leg bone(s) CPT 27360 | $220.92 | $3,156.00 | $28.00 – $8,631.30 | 36 |
| Partial removal of bladder CPT 51550 | $229.46 | $3,278.00 | $70.00 – $1,630.91 | 34 |
| Partial removal of eye fluid CPT 67005 | $117.53 | $1,679.00 | $77.00 – $829.57 | 34 |
| Partial removal of eye fluid CPT 67010 | $133.84 | $1,912.00 | $47.00 – $962.61 | 34 |
| Partial removal of fibula CPT 27641 | $160.86 | $2,298.00 | $101.27 – $1,442.72 | 34 |
| Partial removal of foot bone CPT 28288 | $149.80 | $2,140.00 | $152.00 – $940.59 | 36 |
| Partial removal of hand bone CPT 26230 | $124.81 | $1,783.00 | $59.57 – $987.13 | 34 |
| Partial removal of heart sac 33030 CPT 33030 | $291.83 | $4,169.00 | $75.00 – $2,684.17 | 34 |
| Partial removal of lip CPT 40530 | $99.68 | $1,424.00 | $253.16 – $8,745.94 | 36 |
| Partial removal of lung 32480 CPT 32480 | $337.96 | $4,828.00 | $100.00 – $3,325.11 | 36 |
| Partial removal of nose CPT 30150 | $195.09 | $2,787.00 | $75.00 – $1,691.12 | 34 |
| Partial removal of penis CPT 54120 | $152.74 | $2,182.00 | $55.00 – $1,065.35 | 34 |
| Partial removal of radius CPT 25151 | $145.39 | $2,077.00 | $70.74 – $1,540.01 | 34 |
| Partial removal of radius CPT 25230 | $108.99 | $1,557.00 | $30.00 – $899.33 | 34 |
| Partial removal of rectum CPT 45111 | $256.13 | $3,659.00 | $585.00 – $1,884.11 | 34 |
| Partial removal of rib CPT 21600 | $139.79 | $1,997.00 | $54.36 – $19,141.34 | 36 |
| Partial removal of sternum CPT 21620 | $120.26 | $1,718.00 | $60.00 – $1,044.08 | 34 |
| Partial removal of thyroid CPT 60220 | $169.33 | $2,419.00 | $30.00 – $1,592.85 | 34 |
| Partial removal of thyroid CPT 60225 | $224.49 | $3,207.00 | $118.02 – $15,947.64 | 36 |
| Partial removal of tibia CPT 27640 | $201.67 | $2,881.00 | $40.00 – $1,791.54 | 34 |
| Partial removal of tongue CPT 41120 | $260.54 | $3,722.00 | $60.00 – $1,842.19 | 34 |
| Partial removal of ulna CPT 25119 | $125.51 | $1,793.00 | $84.51 – $1,072.55 | 34 |
| Partial removal of ulna CPT 25240 | $108.29 | $1,547.00 | $50.63 – $946.79 | 34 |
| Partial removal of vaginal wall 57106 CPT 57106 | $130.69 | $1,867.00 | $30.00 – $962.98 | 36 |
| Partial thyroid excision CPT 60210 | $169.33 | $2,419.00 | $112.81 – $15,947.64 | 36 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | $240.87 | $3,441.00 | $731.94 – $2,093.33 | 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.