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 |
|---|---|---|---|---|
| Red blood cells each unit HCPCS P9021 | $19.60 | $280.00 | $150.57 – $689.00 | 21 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $15.89 | $227.00 | $184.91 – $689.00 | 21 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $22.75 | $325.00 | $265.41 – $689.00 | 21 |
| Red cell mass single CPT 78120 | $2.59 | $37.00 | $9.12 – $109.76 | 34 |
| Redo endovas vena cava filtr CPT 37192 | $950.95 | $13,585.00 | $50.00 – $8,329.20 | 36 |
| Reduce bowel obstruction 44050 CPT 44050 | $219.31 | $3,133.00 | $559.57 – $1,707.52 | 36 |
| Reduce testis torsion CPT 54600 | $110.04 | $1,572.00 | $67.39 – $9,298.64 | 36 |
| Reduction of procidentia 45900 CPT 45900 | $50.96 | $728.00 | $50.00 – $333.53 | 34 |
| Re-exploration of chest 32120 CPT 32120 | $202.79 | $2,897.00 | $674.61 – $1,864.80 | 34 |
| Re-explore parathyroids CPT 60502 | $49.21 | $703.00 | $55.00 – $2,660.09 | 34 |
| Refill maint impl spine pump CPT 95991 | $19.67 | $281.00 | $33.69 – $809.72 | 36 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $382.20 | $5,460.00 | $2.68 – $901.20 | 19 |
| Reimplant ureter in bladder CPT 50785 | $288.68 | $4,124.00 | $982.87 – $2,067.57 | 34 |
| Reinforce hip bones CPT 27187 | $242.06 | $3,458.00 | $65.00 – $1,990.86 | 34 |
| Reinsertion of spinal fixation device 22849 CPT 22849 | $308.35 | $4,405.00 | $30.00 – $2,591.21 | 34 |
| Release finger contracture CPT 26525 | $171.43 | $2,449.00 | $30.00 – $1,423.74 | 34 |
| Release forearm/hand tendon CPT 26449 | $175.21 | $2,503.00 | $52.00 – $1,812.90 | 34 |
| Release knuckle contracture CPT 26520 | $170.17 | $2,431.00 | $345.12 – $1,416.62 | 34 |
| Release middle ear bone CPT 69650 | $196.42 | $2,806.00 | $101.27 – $1,283.46 | 34 |
| Release muscles of hand CPT 26593 | $161.56 | $2,308.00 | $40.00 – $1,241.03 | 34 |
| Release of eye fluid CPT 67015 | $148.05 | $2,115.00 | $337.30 – $6,087.86 | 36 |
| Release of foot tendon 28225 CPT 28225 | $66.43 | $949.00 | $70.00 – $8,631.30 | 36 |
| Release of foot tendons CPT 28222 | $91.42 | $1,306.00 | $40.00 – $865.13 | 34 |
| Release of foot tendons CPT 28226 | $99.96 | $1,428.00 | $36.49 – $757.32 | 34 |
| Release of lower leg tendon CPT 27680 | $105.21 | $1,503.00 | $220.40 – $877.97 | 34 |
| Release of lung 32220 CPT 32220 | $368.83 | $5,269.00 | $95.00 – $3,475.94 | 36 |
| Release of shoulder ligament CPT 23415 | $172.76 | $2,468.00 | $67.39 – $1,468.83 | 34 |
| Release of ureter CPT 50715 | $286.30 | $4,090.00 | $70.00 – $1,988.66 | 34 |
| Release palm contracture CPT 26040 | $80.64 | $1,152.00 | $15.00 – $4,241.76 | 36 |
| Release palm contracture CPT 26121 | $149.38 | $2,134.00 | $55.00 – $1,167.47 | 34 |
| Release palm contracture CPT 26123 | $208.25 | $2,975.00 | $55.00 – $1,566.11 | 34 |
| Release palm contracture CPT 26125 | $63.35 | $905.00 | $210.72 – $574.24 | 36 |
| Release palm contracture 26045 CPT 26045 | $118.79 | $1,697.00 | $23.00 – $8,631.30 | 36 |
| Release palm & finger tendon CPT 26442 | $246.61 | $3,523.00 | $52.00 – $1,926.79 | 34 |
| Release palm/finger tendon CPT 26440 | $162.82 | $2,326.00 | $27.00 – $1,357.30 | 34 |
| Release wrist/forearm tendon CPT 25295 | $131.67 | $1,881.00 | $66.64 – $1,414.25 | 34 |
| Relieve bladder contracture CPT 52640 | $79.73 | $1,139.00 | $35.00 – $9,298.64 | 36 |
| Relocation skin pocket aicd CPT 33223 | $94.99 | $1,357.00 | $85.00 – $759.55 | 34 |
| Relocation skin pocket pm CPT 33222 | $80.78 | $1,154.00 | $50.00 – $633.72 | 34 |
| Rem/biv cast full arm/leg CPT 29705 | $30.87 | $441.00 | $10.00 – $304.00 | 36 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $742.88 | $10,612.60 | $2.90 – $18.79 | 22 |
| Rem endovas vena cava filter CPT 37193 | $1,544.27 | $22,061.00 | $50.00 – $8,329.20 | 36 |
| Rem interrog dev eval icpms CPT 93297 | $10.78 | $154.00 | $21.55 – $180.48 | 37 |
| Rem interrog dev eval scrms CPT 93298 | $18.34 | $262.00 | $25.00 – $213.13 | 37 |
| Rem interrog evl pm/ids CPT 93296 | $6.58 | $94.00 | $31.34 – $300.34 | 37 |
| Rem interrog evl pm/ldls pm CPT 93294 | $7.07 | $101.00 | $29.91 – $264.43 | 37 |
| Rem mntr wrls p-art prs snr CPT 93264 | $5.95 | $85.00 | $29.85 – $130.85 | 34 |
| Remote 30 day ecg rev/report CPT 93228 | $4.41 | $63.00 | $21.55 – $209.87 | 37 |
| Remote 30 day ecg tech supp CPT 93229 | $670.53 | $9,579.00 | $674.96 – $8,615.01 | 34 |
| Removal abdomen lymph nodes 38564 CPT 38564 | $166.67 | $2,381.00 | $40.00 – $1,453.45 | 34 |
| Removal anal seton other marker 46030 CPT 46030 | $63.35 | $905.00 | $70.36 – $304.00 | 36 |
| Removal biliary drg cath CPT 47537 | $22.61 | $323.00 | $30.00 – $1,386.98 | 34 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $381.36 | $5,448.00 | $70.00 – $304.00 | 36 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $573.02 | $8,186.00 | $65.00 – $469.00 | 36 |
| Removal cerclage w/anes CPT 59871 | $30.73 | $439.00 | $26.86 – $292.05 | 34 |
| Removal cerclage without anes CPT 59899 | $17.99 | $257.00 | $5.00 – $74.00 | 9 |
| Removal cerumen impacted (both sides) CPT 69210 | $17.71 | $253.00 | $26.79 – $155.62 | 36 |
| Removal clot in graft oth/thn 35875 CPT 35875 | $132.58 | $1,894.00 | $60.00 – $14,678.70 | 36 |
| Removal clot in graft xcp 35876 CPT 35876 | $210.07 | $3,001.00 | $30.00 – $1,779.91 | 34 |
| Removal deep drug delivery device CPT 20701 | $14.98 | $214.00 | $45.00 – $135.26 | 34 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $50.68 | $724.00 | $27.54 – $304.00 | 27 |
| Removal foreign body extrn auditory canal with anes CPT 69205 | $23.45 | $335.00 | $80.42 – $4,356.78 | 36 |
| Removal foreign body foot cmplx CPT 28193 | $128.87 | $1,841.00 | $40.00 – $905.55 | 36 |
| Removal foreign body foot subcutaneous right CPT 28190 | $81.20 | $1,160.00 | $123.98 – $415.05 | 36 |
| Removal implant from finger/hand 26320 CPT 26320 | $88.34 | $1,262.00 | $295.23 – $4,356.78 | 36 |
| Removal implant superficial separate procedure CPT 20670 | $88.55 | $1,265.00 | $115.79 – $932.55 | 36 |
| Removal kidney open radical CPT 50230 | $302.96 | $4,328.00 | $207.74 – $2,199.10 | 34 |
| Removal mamma implant mat 19330 CPT 19330 | $157.36 | $2,248.00 | $85.63 – $1,251.37 | 34 |
| Removal neck/armpit lesion CPT 38550 | $126.21 | $1,803.00 | $40.00 – $964.40 | 34 |
| Removal of adenoids CPT 42830 | $53.27 | $761.00 | $118.02 – $8,745.94 | 36 |
| Removal of adenoids CPT 42831 | $57.96 | $828.00 | $50.00 – $8,745.94 | 36 |
| Removal of adenoids CPT 42836 | $61.11 | $873.00 | $36.00 – $8,745.94 | 36 |
| Removal of adenoids <12yrs 42835 CPT 42835 | $49.77 | $711.00 | $55.00 – $336.67 | 34 |
| Removal of anal fissure CPT 46200 | $84.98 | $1,214.00 | $50.00 – $525.42 | 34 |
| Removal of anal tags CPT 46230 | $77.35 | $1,105.00 | $25.00 – $364.42 | 36 |
| Removal of ankle/heel lesion CPT 28100 | $104.02 | $1,486.00 | $40.00 – $8,631.30 | 36 |
| Removal of ankle implant CPT 27704 | $139.16 | $1,988.00 | $65.00 – $1,098.65 | 34 |
| Removal of arm artery clot 34111 CPT 34111 | $133.70 | $1,910.00 | $35.00 – $14,678.70 | 36 |
| Removal of artery clot 34101 CPT 34101 | $134.05 | $1,915.00 | $70.00 – $14,678.70 | 36 |
| Removal of artery clot 34151 CPT 34151 | $309.68 | $4,424.00 | $35.00 – $2,605.80 | 34 |
| Removal of artery clot; neck incision 34001 CPT 34001 | $203.28 | $2,904.00 | $118.02 – $1,715.85 | 34 |
| Removal of bladder lesion CPT 51520 | $144.20 | $2,060.00 | $35.00 – $1,010.11 | 34 |
| Removal of bladder lesion CPT 51525 | $205.38 | $2,934.00 | $744.60 – $1,540.78 | 36 |
| Removal of bladder lesion CPT 51530 | $184.94 | $2,642.00 | $626.95 – $1,391.62 | 36 |
| Removal of bladder stone CPT 51050 | $114.73 | $1,639.00 | $45.00 – $14,144.02 | 36 |
| Removal of bone for graft CPT 20900 | $42.98 | $614.00 | $35.00 – $1,157.98 | 34 |
| Removal of bone for graft CPT 20902 | $64.96 | $928.00 | $45.00 – $1,198.31 | 34 |
| Removal of bone lesion CPT 23140 | $137.90 | $1,970.00 | $57.00 – $996.62 | 34 |
| Removal of breast lesion CPT 19120 | $385.00 | $5,500.00 | $152.00 – $770.95 | 36 |
| Removal of calcium deposits CPT 23000 | $89.53 | $1,279.00 | $65.00 – $7,662.42 | 36 |
| Removal of colon/ileostomy CPT 44156 | $533.33 | $7,619.00 | $60.00 – $3,904.87 | 34 |
| Removal of epididymis CPT 54860 | $102.06 | $1,458.00 | $329.11 – $699.71 | 34 |
| Removal of ethmoid sinus CPT 31200 | $235.41 | $3,363.00 | $70.00 – $1,147.22 | 34 |
| Removal of eye lesion CPT 65400 | $148.40 | $2,120.00 | $49.00 – $1,200.00 | 34 |
| Removal of eye lesion CPT 65426 | $117.81 | $1,683.00 | $54.00 – $1,213.05 | 34 |
| Removal of face wrinkles CPT 15828 | $147.49 | $2,107.00 | $16.52 – $9,348.08 | 27 |
| Removal of fallopian tube 58700 CPT 58700 | $191.45 | $2,735.00 | $608.04 – $1,583.92 | 34 |
| Removal of fascia for graft CPT 20920 | $98.70 | $1,410.00 | $60.00 – $780.68 | 34 |
| Removal of fascia for graft CPT 20922 | $120.89 | $1,727.00 | $469.72 – $1,136.62 | 27 |
| Removal of finger lesion CPT 26210 | $184.87 | $2,641.00 | $285.93 – $4,241.76 | 36 |
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.