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 |
|---|---|---|---|---|
| Psytx complex interactive CPT 90785 | $2.52 | $36.00 | $3.88 – $23.88 | 36 |
| Psytx pt w/e&m 16-37 min CPT 90833 | $13.02 | $186.00 | $17.41 – $132.60 | 36 |
| Psytx pt w/e&m 38-52 min CPT 90836 | $16.52 | $236.00 | $56.02 – $167.86 | 36 |
| Psytx pt w/e&m 53+ min CPT 90838 | $21.91 | $313.00 | $90.57 – $222.02 | 36 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $22.61 | $323.00 | $8.66 – $445.00 | 37 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $14.63 | $209.00 | $4.94 – $445.00 | 17 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $16.17 | $231.00 | $7.43 – $445.00 | 37 |
| Pt application of modality traction mechanical CPT 97012 | $22.61 | $323.00 | $11.14 – $445.00 | 37 |
| Pten gene known fam variant CPT 81322 | $2.66 | $38.05 | $38.05 – $93.20 | 23 |
| Pt evaluation high complexity patient/family CPT 97163 | $72.80 | $1,040.00 | $103.01 – $499.00 | 25 |
| Pt evaluation low complexity patient/family CPT 97161 | $38.92 | $556.00 | $71.52 – $445.00 | 37 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $49.56 | $708.00 | $71.52 – $445.00 | 37 |
| Pt-focused hlth risk assmt CPT 96160 | $1.68 | $24.00 | $3.25 – $98.84 | 36 |
| Pt re-evaluation patient/family CPT 97164 | $28.49 | $407.00 | $71.23 – $499.00 | 25 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $26.67 | $381.00 | $30.28 – $445.00 | 30 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $5.46 | $78.00 | $78.00 – $304.00 | 17 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $25.06 | $358.00 | $11.28 – $445.00 | 37 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $21.00 | $300.00 | $14.76 – $499.00 | 25 |
| Pt wheelchair management each 15 minutes CPT 97542 | $22.61 | $323.00 | $32.59 – $499.00 | 24 |
| Pul art balloon repr percut CPT 92997 | $102.55 | $1,465.00 | $525.22 – $1,129.39 | 34 |
| Pul art balloon repr percut CPT 92998 | $51.17 | $731.00 | $261.37 – $562.46 | 34 |
| Pulmonary decortication partial 32225 CPT 32225 | $229.67 | $3,281.00 | $65.00 – $2,141.33 | 34 |
| Pulmonary vent imaging CPT 78579 | $219.94 | $3,142.00 | $22.70 – $1,306.39 | 37 |
| Pulse ox continuous overnight monitoring CPT 94762 | $115.85 | $1,655.00 | $26.17 – $343.71 | 29 |
| Pulse ox multiple CPT 94761 | $37.80 | $540.00 | $4.57 – $232.72 | 29 |
| Pulse ox single CPT 94760 | $19.39 | $277.00 | $3.23 – $90.01 | 36 |
| Punc of shunt for asp or inj CPT 61070 | $13.44 | $192.00 | $30.00 – $1,862.06 | 36 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $43.54 | $622.00 | $12.66 – $350.97 | 36 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $277.69 | $3,967.00 | $46.91 – $304.00 | 36 |
| Puncture/clear windpipe 31612 CPT 31612 | $11.34 | $162.00 | $20.00 – $8,745.94 | 36 |
| Puncture spinal lumbar diagnostic CPT 62270 | $264.74 | $3,782.00 | $18.00 – $304.00 | 36 |
| Puraply 1 sq cm HCPCS Q4195 | $148.47 | $2,121.00 | $98.08 – $346.14 | 20 |
| Pyelotomy w/removal calculus CPT 50130 | $246.61 | $3,523.00 | $45.00 – $1,765.07 | 34 |
| Pyloroplasty 43800 CPT 43800 | $217.49 | $3,107.00 | $497.00 – $1,690.16 | 36 |
| Pyruvate CPT 84210 | $1.01 | $14.48 | $3.97 – $119.41 | 23 |
| Pyruvate kinase CPT 84220 | $0.59 | $8.39 | $3.14 – $103.71 | 23 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $366.45 | $5,235.00 | $38.43 – $2,270.76 | 37 |
| Quant diff pulm perf w/imaging CPT 78597 | $9.24 | $132.00 | $33.75 – $224.41 | 34 |
| Quest t3 uptake CPT 84479 | $26.67 | $381.00 | $2.29 – $71.14 | 23 |
| Rabies ig ht&sol human im/sc CPT 90377 | $3,130.46 | $44,720.90 | $199.54 – $486.40 | 26 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $353.50 | $5,050.00 | $40.19 – $562.37 | 29 |
| Racepinephrine hcl soln nebu 2.25% (base equivalent) HCPCS J7699 | $1.75 | $25.00 | $9.00 – $74.00 | 11 |
| Radiation therapy dose plan CPT 77300 | $9.24 | $132.00 | $33.73 – $423.42 | 37 |
| Radiation treatment aid(s) CPT 77332 | $6.72 | $96.00 | $24.46 – $74.49 | 34 |
| Radiation treatment aid(s) CPT 77333 | $11.20 | $160.00 | $25.27 – $74.64 | 34 |
| Radiation treatment aid(s) CPT 77334 | $17.01 | $243.00 | $62.00 – $1,019.55 | 37 |
| Radiation tx management x5 CPT 77427 | $53.83 | $769.00 | $114.37 – $1,370.21 | 37 |
| Radical abdominal hysterectomy 58210 CPT 58210 | $434.21 | $6,203.00 | $1,520.10 – $3,662.49 | 34 |
| Radical resection of elbow CPT 24149 | $289.03 | $4,129.00 | $60.00 – $2,240.02 | 34 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | $247.59 | $3,537.00 | $30.00 – $7,662.42 | 36 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | $342.44 | $4,892.00 | $227.85 – $7,662.42 | 36 |
| Radiotherapy dose plan imrt CPT 77301 | $118.44 | $1,692.00 | $432.51 – $2,436.41 | 34 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,616.09 | $23,087.00 | $36.36 – $1,550.94 | 37 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $12.74 | $182.00 | $45.90 – $763.85 | 34 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,831.69 | $26,167.00 | $50.08 – $1,681.72 | 37 |
| Radphm lcl tumor plr sgl day CPT 78800 | $515.48 | $7,364.00 | $30.73 – $1,054.57 | 37 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | $244.79 | $3,497.00 | $943.42 – $1,601.71 | 27 |
| Rad resect abd tumor 5 cm/> CPT 22905 | $314.72 | $4,496.00 | $68.00 – $7,662.42 | 36 |
| Rad resect hand tumor < 3 cm CPT 26117 | $183.75 | $2,625.00 | $686.89 – $7,662.42 | 36 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | $227.85 | $3,255.00 | $133.66 – $7,662.42 | 36 |
| Rapid Strep Test CPT 87880 | $28.42 | $406.00 | $3.18 – $88.94 | 36 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $1,975.98 | $28,228.30 | $57.93 – $21,577.90 | 22 |
| Rbc count only automated CPT 85041 | $0.19 | $2.67 | $0.98 – $33.09 | 23 |
| Rbc osmotic fragility CPT 85555 | $5.09 | $72.73 | $2.09 – $73.51 | 23 |
| Realignment of knee CPT 27457 | $231.28 | $3,304.00 | $85.00 – $1,943.41 | 34 |
| Realignment of tendons CPT 26437 | $166.74 | $2,382.00 | $60.00 – $1,309.84 | 34 |
| Rebuild eardrum structures CPT 69632 | $264.46 | $3,778.00 | $70.00 – $1,726.12 | 34 |
| Rebuild eardrum structures CPT 69633 | $257.53 | $3,679.00 | $819.06 – $1,658.02 | 34 |
| Rebuild eardrum structures CPT 69636 | $347.20 | $4,960.00 | $893.52 – $2,247.36 | 34 |
| Rebuild outer ear canal CPT 69310 | $276.57 | $3,951.00 | $60.00 – $1,754.93 | 34 |
| Rechanneling of artery CPT 35361 | $336.63 | $4,809.00 | $238.27 – $2,962.70 | 34 |
| Rechanneling of artery CPT 35306 | $97.30 | $1,390.00 | $374.11 – $844.20 | 34 |
| Rechanneling of artery CPT 35363 | $358.89 | $5,127.00 | $1,193.59 – $3,168.60 | 34 |
| Rechanneling of artery 35305 CPT 35305 | $271.11 | $3,873.00 | $1,036.26 – $2,248.91 | 34 |
| Rechanneling of artery 35341 CPT 35341 | $305.76 | $4,368.00 | $152.00 – $2,617.24 | 36 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | $282.52 | $4,036.00 | $50.00 – $2,340.42 | 36 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | $321.79 | $4,597.00 | $45.00 – $2,743.07 | 34 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | $216.86 | $3,098.00 | $208.49 – $14,678.70 | 36 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | $272.09 | $3,887.00 | $80.00 – $2,248.91 | 34 |
| Reconst lwr jaw w/fixation CPT 21196 | $349.58 | $4,994.00 | $1,042.44 – $2,845.11 | 34 |
| Reconstruct ankle joint CPT 27702 | $233.24 | $3,332.00 | $185.41 – $2,012.22 | 34 |
| Reconstruct elbow joint CPT 24360 | $220.08 | $3,144.00 | $30.00 – $1,786.79 | 34 |
| Reconstruct elbow lat ligmnt CPT 24344 | $269.92 | $3,856.00 | $60.00 – $2,149.85 | 34 |
| Reconstruct elbow med ligmnt CPT 24346 | $269.92 | $3,856.00 | $818.69 – $2,135.61 | 34 |
| Reconstruct finger joint CPT 26545 | $182.56 | $2,608.00 | $35.00 – $1,449.84 | 34 |
| Reconstruct finger joint CPT 26548 | $198.73 | $2,839.00 | $65.00 – $1,594.59 | 34 |
| Reconstruct head of radius CPT 24365 | $158.13 | $2,259.00 | $60.00 – $1,267.13 | 34 |
| Reconstruct head of radius CPT 24366 | $167.86 | $2,398.00 | $30.00 – $1,357.30 | 34 |
| Reconstruction knee CPT 27427 | $173.95 | $2,485.00 | $90.00 – $1,418.99 | 34 |
| Reconstruction knee CPT 27428 | $272.58 | $3,894.00 | $70.00 – $2,166.46 | 34 |
| Reconstruction knee CPT 27429 | $307.23 | $4,389.00 | $959.79 – $2,420.36 | 34 |
| Reconstruction of hip socket CPT 27122 | $266.56 | $3,808.00 | $168.65 – $2,204.42 | 34 |
| Reconstruction of nail bed CPT 11762 | $45.99 | $657.00 | $32.76 – $5,442.78 | 36 |
| Reconstruction of nose CPT 30410 | $347.97 | $4,971.00 | $147.43 – $2,648.66 | 34 |
| Reconstruction of nose CPT 30420 | $353.71 | $5,053.00 | $30.00 – $2,868.05 | 34 |
| Reconstruction tongue fold CPT 41520 | $62.65 | $895.00 | $234.55 – $8,745.94 | 36 |
| Reconstruct lip with flap CPT 40527 | $153.51 | $2,193.00 | $111.69 – $15,616.06 | 36 |
| Reconstruct shoulder joint CPT 23470 | $288.89 | $4,127.00 | $168.65 – $2,448.83 | 34 |
| Reconstruct shoulder joint CPT 23472 | $346.71 | $4,953.00 | $45.00 – $3,018.33 | 34 |
| Reconstruct ulna/radioulnar CPT 25337 | $220.15 | $3,145.00 | $79.30 – $1,786.79 | 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.