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 |
|---|---|---|---|---|
| Placement of drain pancreas CPT 48001 | $532.21 | $7,603.00 | $155.62 – $4,021.05 | 34 |
| Placement of seton CPT 46020 | $27.93 | $399.00 | $110.03 – $7,321.98 | 36 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $2,740.57 | $39,151.00 | $78.56 – $30,452.80 | 36 |
| Place needles h&n for right CPT 41019 | $119.84 | $1,712.00 | $72.60 – $669.42 | 34 |
| Place non-slctv cath thoracic arta CPT 36221 | $44.73 | $639.00 | $20.00 – $3,525.50 | 34 |
| Placental lactogen CPT 83632 | $10.22 | $146.00 | $7.52 – $222.23 | 23 |
| Place right device/marker pros CPT 55876 | $36.89 | $527.00 | $91.56 – $304.00 | 36 |
| Place slctv cath carotd art uni CPT 36224 | $125.37 | $1,791.00 | $20.00 – $5,191.02 | 34 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $1,237.67 | $17,681.00 | $20.00 – $8,329.20 | 36 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $111.86 | $1,598.00 | $15.00 – $4,776.93 | 34 |
| Place slctv cath subclavian art CPT 36225 | $73.99 | $1,057.00 | $15.00 – $4,740.32 | 34 |
| Place slctv cath vertebral art uni CPT 36226 | $83.02 | $1,186.00 | $40.00 – $5,293.97 | 34 |
| Platelet aggregation each agent teg CPT 85576 | $1.74 | $24.91 | $4.19 – $200.69 | 23 |
| Platelet automated CPT 85049 | $37.31 | $533.00 | $1.03 – $49.23 | 23 |
| Platelets hla matched leukocytes reduced apheresis/pheresis each unit HCPCS P9052 | $56.36 | $805.18 | $629.00 – $1,416.12 | 21 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $36.40 | $520.00 | $499.53 – $1,023.18 | 24 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $48.51 | $693.00 | $617.33 – $1,361.22 | 24 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $57.75 | $825.00 | $595.00 – $1,214.86 | 21 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $1,517.67 | $21,681.00 | $10.00 – $9,444.82 | 36 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $1,400.84 | $20,012.00 | $175.31 – $3,921.75 | 18 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $879.55 | $12,565.00 | $35.00 – $9,298.64 | 36 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $897.05 | $12,815.00 | $35.00 – $9,298.64 | 36 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $19.74 | $282.00 | $32.00 – $1,868.00 | 36 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $9.94 | $142.00 | $36.02 – $958.49 | 34 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $14.91 | $213.00 | $40.00 – $1,628.84 | 34 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $9.87 | $141.00 | $35.66 – $924.23 | 36 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $184.73 | $2,639.00 | $12.33 – $984.36 | 37 |
| Plmt biliary drainage cath CPT 47534 | $85.47 | $1,221.00 | $15.00 – $5,654.60 | 34 |
| Plmt nephroureteral catheter CPT 50433 | $829.85 | $11,855.00 | $217.61 – $9,298.64 | 36 |
| Plmt ureteral stent prq CPT 50694 | $1,055.11 | $15,073.00 | $65.00 – $9,298.64 | 36 |
| Pm device progr eval dual CPT 93280 | $13.93 | $199.00 | $32.87 – $183.28 | 37 |
| Pm device progr eval multi CPT 93281 | $16.03 | $229.00 | $38.15 – $214.53 | 37 |
| Pmp22 gene dup/delet CPT 81324 | $36.40 | $520.00 | $520.00 – $5,041.24 | 22 |
| Pm phone r-strip device eval CPT 93293 | $12.67 | $181.00 | $13.66 – $336.72 | 37 |
| Pms2 known familial variants CPT 81318 | $23.17 | $331.00 | $103.48 – $662.00 | 23 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $78.96 | $1,128.00 | $3.00 – $212.75 | 23 |
| Polysom <6 yrs cpap/bilvl CPT 95783 | $22.82 | $326.00 | $135.27 – $8,174.96 | 37 |
| Polysom any age 1-3> param CPT 95808 | $423.64 | $6,052.00 | $83.53 – $2,265.30 | 37 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $549.50 | $7,850.00 | $127.05 – $2,265.30 | 37 |
| Post 1 srfc resinbased cmpst HCPCS D2391 | $26.25 | $375.00 | $152.00 – $535.88 | 17 |
| Post 2 srfc resinbased cmpst HCPCS D2392 | $24.08 | $344.00 | $152.00 – $491.58 | 17 |
| Post >=4srfc resinbase cmpst HCPCS D2394 | $29.75 | $425.00 | $152.00 – $607.33 | 17 |
| Post non-seg/spine instrumentation 22840 CPT 22840 | $172.41 | $2,463.00 | $73.72 – $1,613.57 | 34 |
| Postpartum Care Only CPT 59430 | $62.79 | $897.00 | $146.13 – $641.30 | 36 |
| Post seg spine instrument/3-6 seg 22842 CPT 22842 | $173.88 | $2,484.00 | $30.00 – $1,613.57 | 34 |
| Potassium 24 hour urine CPT 84133 | $11.41 | $163.00 | $1.46 – $47.30 | 23 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $37.65 | $537.81 | $0.27 – $227.79 | 10 |
| Potassium serum/plasma/whole blood CPT 84132 | $40.81 | $583.00 | $1.46 – $51.00 | 23 |
| Pq dr cath chg w cont s&i CPT 75984 | $255.36 | $3,648.00 | $37.37 – $553.25 | 37 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $2,646.70 | $37,810.00 | $30.00 – $19,141.34 | 36 |
| Pq thr inj ext pse CPT 36002 | $212.80 | $3,040.00 | $215.32 – $1,654.78 | 18 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $47.88 | $684.00 | $25.00 – $2,455.95 | 34 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $1,611.05 | $23,015.00 | $60.00 – $8,631.30 | 36 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $1,828.68 | $26,124.00 | $25.00 – $8,631.30 | 36 |
| Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 | $176.61 | $2,523.00 | $57.00 – $8,631.30 | 36 |
| Pr application of long arm splint CPT 29105 | $44.38 | $634.00 | $36.13 – $304.00 | 36 |
| Pr application splint static short arm CPT 29125 | $37.87 | $541.00 | $10.00 – $304.00 | 36 |
| Pr assessment emotional/behavioral per instrument brief CPT 96127 | $1.40 | $20.00 | $4.81 – $98.53 | 37 |
| Pr biopsy skin punch single lesion CPT 11104 | $84.56 | $1,208.00 | $37.91 – $304.00 | 36 |
| Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 | $147.56 | $2,108.00 | $80.04 – $1,436.49 | 34 |
| Pr correction hammertoe CPT 28285 | $134.61 | $1,923.00 | $152.00 – $760.02 | 36 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $6.86 | $98.00 | $10.41 – $98.84 | 36 |
| Prcrd drg 6+yr without anomly CPT 33017 | $55.58 | $794.00 | $35.00 – $569.66 | 36 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $55.44 | $792.00 | $60.00 – $9,298.64 | 36 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $70.91 | $1,013.00 | $24.21 – $304.00 | 36 |
| Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 | $14.28 | $204.00 | $37.60 – $151.60 | 36 |
| Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 | $20.16 | $288.00 | $53.40 – $216.22 | 36 |
| Prealbumin CPT 84134 | $39.13 | $559.00 | $5.38 – $160.86 | 23 |
| Pr ecg 12 lead report only CPT 93010 | $2.80 | $40.00 | $8.52 – $111.93 | 37 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | $4.62 | $66.00 | $18.21 – $418.80 | 37 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $5.70 | $81.36 | $0.25 – $12.88 | 10 |
| Prednisone 1 mg tablet HCPCS J7512 | $1.61 | $23.00 | $0.01 – $5.80 | 19 |
| Prefab stnlss steel crown pe HCPCS D2931 | $42.14 | $602.00 | $152.00 – $860.26 | 17 |
| Prefab stnlss steel crwn pri HCPCS D2930 | $29.61 | $423.00 | $152.00 – $604.47 | 17 |
| Pregabalin - sendout CPT 80366 | $4.81 | $68.75 | $0.03 – $5.72 | 6 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $218.96 | $3,128.00 | $176.41 – $5,061.94 | 36 |
| Pregnancy associated plasma protein-a CPT 84163 | $0.94 | $13.38 | $3.69 – $162.12 | 23 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $313.46 | $4,478.00 | $48.12 – $580.43 | 37 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $250.60 | $3,580.00 | $42.11 – $310.67 | 37 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | $24.43 | $349.00 | $101.29 – $304.00 | 27 |
| Prenatal Care Only (4-6 visits) CPT 59425 | $133.07 | $1,901.00 | $152.00 – $1,554.30 | 36 |
| Prenatal Care Only (7+ visits) CPT 59426 | $243.25 | $3,475.00 | $152.00 – $2,850.10 | 36 |
| Prepare fecal microbiota CPT 44705 | $29.26 | $418.00 | $74.00 – $501.60 | 14 |
| Prep skin to 100cm2 other CPT 15004 | $96.25 | $1,375.00 | $65.15 – $601.09 | 36 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $52.15 | $745.00 | $53.98 – $1,949.62 | 36 |
| Prep skn trk/ext adl 100cm2 CPT 15003 | $10.29 | $147.00 | $38.14 – $111.01 | 34 |
| Pressure max expiratory/inspiratory CPT 94799 | $46.62 | $666.00 | $169.72 – $402.00 | 15 |
| Pressure velocity wire add ves CPT 93572 | $376.25 | $5,375.00 | $70.97 – $145.20 | 34 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $31.50 | $450.00 | $6.58 – $449.42 | 23 |
| Pretreat rbc absorption reference CPT 86978 | $11.06 | $158.00 | $7.89 – $689.00 | 24 |
| Pretreat rbc density gradient separation reference CPT 86972 | $8.40 | $120.00 | $6.58 – $449.42 | 23 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $12.20 | $174.35 | $4.52 – $158.34 | 23 |
| Pretreat rbc w enzyme reference CPT 86971 | $5.34 | $76.25 | $6.83 – $449.42 | 23 |
| Pr evaluation psychiatric diagnostic w/medical services CPT 90792 | $33.60 | $480.00 | $103.25 – $468.22 | 36 |
| Preventive counseling group CPT 99411 | $1.75 | $25.00 | $25.00 – $304.00 | 18 |
| Preventive counseling group CPT 99412 | $2.80 | $40.00 | $32.04 – $304.00 | 18 |
| Prev med cnsl indiv apprx 15 CPT 99401 | $5.32 | $76.00 | $17.82 – $304.00 | 27 |
| Prev med cnsl indiv apprx 30 CPT 99402 | $10.78 | $154.00 | $35.22 – $304.00 | 27 |
| Prev med cnsl indiv apprx 45 CPT 99403 | $16.17 | $231.00 | $52.84 – $330.10 | 18 |
| Prev med cnsl indiv apprx 60 CPT 99404 | $21.63 | $309.00 | $70.45 – $441.56 | 18 |
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.