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 |
|---|---|---|---|---|
| Repair artery rupture aorta CPT 35103 | $477.47 | $6,821.00 | $135.00 – $4,200.40 | 34 |
| Repair art rupture aorta 35082 CPT 35082 | $480.06 | $6,858.00 | $65.00 – $4,047.12 | 36 |
| Repair art rupture groin 35132 CPT 35132 | $361.13 | $5,159.00 | $130.00 – $3,166.32 | 34 |
| Repair av fistula ext 35190 CPT 35190 | $170.45 | $2,435.00 | $637.75 – $1,388.69 | 34 |
| Repair biceps tendon CPT 23430 | $182.70 | $2,610.00 | $30.00 – $1,475.94 | 34 |
| Repair bladder defect CPT 57288 | $178.85 | $2,555.00 | $300.00 – $13,196.08 | 36 |
| Repair blood ves direct neck 35201 CPT 35201 | $210.28 | $3,004.00 | $35.00 – $14,678.70 | 36 |
| Repair blood vess/direct/intra/abd 35221 CPT 35221 | $332.85 | $4,755.00 | $253.16 – $2,573.78 | 36 |
| Repair blood vessel direct hand finger CPT 35207 | $183.75 | $2,625.00 | $25.00 – $1,272.02 | 34 |
| Repair blood vessel dir lower extr CPT 35226 | $186.13 | $2,659.00 | $70.00 – $1,583.16 | 34 |
| Repair blood vessel dir upper extr CPT 35206 | $182.77 | $2,611.00 | $102.75 – $8,329.20 | 36 |
| Repair blood vessel lesion CPT 35184 | $214.48 | $3,064.00 | $828.09 – $1,903.45 | 27 |
| Repair blood vessel lesion CPT 35188 | $297.85 | $4,255.00 | $75.00 – $1,747.79 | 34 |
| Repair blood vessel lesion CPT 35266 | $195.37 | $2,791.00 | $45.00 – $1,599.17 | 34 |
| Repair blood vessel w/graft lower extremity 35286 CPT 35256 | $228.83 | $3,269.00 | $883.02 – $1,924.04 | 34 |
| Repair bowel-bladder fistula 44660 CPT 44660 | $314.09 | $4,487.00 | $590.47 – $2,411.21 | 34 |
| Repair bowel-bladder fistula 44661 CPT 44661 | $359.66 | $5,138.00 | $816.08 – $2,754.99 | 34 |
| Repair bowel fistula 44650 CPT 44650 | $334.60 | $4,780.00 | $30.00 – $2,553.46 | 34 |
| Repair carpal bone shorten CPT 25394 | $192.43 | $2,749.00 | $122.49 – $1,511.54 | 34 |
| Repair cleft hand CPT 26580 | $374.92 | $5,356.00 | $35.00 – $2,626.80 | 34 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $105.07 | $1,501.00 | $46.00 – $598.38 | 36 |
| Repair corporeal tear CPT 54437 | $164.57 | $2,351.00 | $118.39 – $2,291.17 | 34 |
| Repair defect arm art 35045 CPT 35045 | $217.14 | $3,102.00 | $40.00 – $14,678.70 | 36 |
| Repair defect of artery CPT 35131 | $308.56 | $4,408.00 | $238.27 – $2,630.97 | 34 |
| Repair defect of artery CPT 35005 | $221.90 | $3,170.00 | $45.00 – $1,919.46 | 34 |
| Repair defect of artery CPT 35021 | $287.42 | $4,106.00 | $65.00 – $2,228.32 | 34 |
| Repair defect of artery CPT 35091 | $393.12 | $5,616.00 | $40.00 – $3,470.59 | 34 |
| Repair defect of artery CPT 35111 | $294.28 | $4,204.00 | $130.00 – $2,582.93 | 34 |
| Repair defect of artery 35011 CPT 35011 | $225.82 | $3,226.00 | $65.00 – $14,678.70 | 36 |
| Repair defect of artery 35081 CPT 35081 | $383.32 | $5,476.00 | $35.00 – $3,175.47 | 34 |
| Repair defect of artery 35102 CPT 35102 | $416.01 | $5,943.00 | $65.00 – $3,454.58 | 34 |
| Repair defect of artery 35121 CPT 35121 | $349.37 | $4,991.00 | $135.00 – $3,102.26 | 34 |
| Repair defect of artery aneurysm 35151 CPT 35151 | $275.03 | $3,929.00 | $1,042.44 – $2,365.59 | 34 |
| Repair defect of artery carotid subclav 35001 CPT 35001 | $247.87 | $3,541.00 | $75.00 – $2,123.08 | 34 |
| Repair deformity of toe CPT 28313 | $90.44 | $1,292.00 | $75.00 – $832.79 | 34 |
| Repair degenerated kneecap CPT 27418 | $200.13 | $2,859.00 | $134.77 – $1,653.91 | 34 |
| Repair dental ellis ii fx CPT 41899 | $14.77 | $211.00 | $38.00 – $74.00 | 2 |
| Repair detached retina pc CPT 67105 | $67.41 | $963.00 | $72.00 – $1,273.05 | 34 |
| Repair eardrum structures CPT 69631 | $218.05 | $3,115.00 | $819.06 – $1,390.85 | 34 |
| Repair elbow deb/attch open CPT 24359 | $163.87 | $2,341.00 | $375.00 – $8,631.30 | 36 |
| Repair elbow perc CPT 24357 | $104.09 | $1,487.00 | $316.08 – $8,631.30 | 36 |
| Repair elbow w/deb open CPT 24358 | $132.65 | $1,895.00 | $35.00 – $8,631.30 | 36 |
| Repair extns tendon finger without grft ea CPT 26418 | $184.87 | $2,641.00 | $152.00 – $1,226.79 | 36 |
| Repair eyelid defect CPT 67903 | $117.53 | $1,679.00 | $421.60 – $1,202.61 | 34 |
| Repair eyelid defect CPT 67908 | $106.33 | $1,519.00 | $389.60 – $905.22 | 34 |
| Repair eyelid defect CPT 67914 | $81.48 | $1,164.00 | $45.00 – $751.31 | 34 |
| Repair eyelid defect CPT 67916 | $105.77 | $1,511.00 | $50.00 – $1,014.78 | 34 |
| Repair eyelid defect CPT 67917 | $111.86 | $1,598.00 | $84.51 – $6,271.62 | 36 |
| Repair eyelid defect CPT 67921 | $77.56 | $1,108.00 | $45.00 – $6,271.62 | 36 |
| Repair eyelid defect CPT 67923 | $105.77 | $1,511.00 | $337.68 – $1,066.96 | 34 |
| Repair eyelid defect CPT 67924 | $112.07 | $1,601.00 | $405.73 – $1,113.91 | 34 |
| Repair fibula nonunion CPT 27726 | $232.12 | $3,316.00 | $85.00 – $1,758.32 | 34 |
| Repair finger/hand tendon CPT 26350 | $186.90 | $2,670.00 | $30.00 – $1,532.89 | 34 |
| Repair finger/hand tendon CPT 26356 | $374.57 | $5,351.00 | $433.36 – $8,631.30 | 36 |
| Repair finger/hand tendon CPT 26370 | $195.09 | $2,787.00 | $81.16 – $1,658.66 | 34 |
| Repair finger/hand tendon CPT 26373 | $217.91 | $3,113.00 | $30.00 – $1,817.64 | 34 |
| Repair finger/hand tendon CPT 26426 | $126.28 | $1,804.00 | $57.00 – $1,445.10 | 34 |
| Repair finger tendon CPT 26433 | $143.01 | $2,043.00 | $65.00 – $1,143.74 | 34 |
| Repair foot dislocation CPT 28555 | $159.67 | $2,281.00 | $617.95 – $1,314.68 | 27 |
| Repair foot dislocation CPT 28615 | $204.61 | $2,923.00 | $807.49 – $1,299.04 | 27 |
| Repair forearm tendon/muscle CPT 25272 | $139.02 | $1,986.00 | $70.00 – $1,499.67 | 34 |
| Repair forearm tendon/muscle CPT 25274 | $165.20 | $2,360.00 | $80.04 – $1,710.86 | 34 |
| Repair forearm tendon/muscle sec 25263 CPT 25263 | $157.64 | $2,252.00 | $75.00 – $1,604.08 | 34 |
| Repair forearm tendon sheath CPT 25275 | $166.88 | $2,384.00 | $104.99 – $1,316.96 | 34 |
| Repair/graft achilles tendon CPT 27652 | $163.52 | $2,336.00 | $118.02 – $1,509.16 | 34 |
| Repair/graft femur head/neck CPT 27170 | $281.68 | $4,024.00 | $30.00 – $2,353.92 | 34 |
| Repair/graft finger tendon CPT 26420 | $184.10 | $2,630.00 | $52.00 – $1,530.52 | 34 |
| Repair/graft finger tendon CPT 26428 | $197.82 | $2,826.00 | $92.70 – $1,589.84 | 34 |
| Repair/graft hand tendon CPT 26352 | $206.71 | $2,953.00 | $30.00 – $1,727.47 | 34 |
| Repair/graft hand tendon CPT 26358 | $242.06 | $3,458.00 | $65.00 – $1,943.41 | 34 |
| Repair/graft hand tendon CPT 26392 | $246.12 | $3,516.00 | $539.84 – $2,054.93 | 34 |
| Repair/graft hand tendon CPT 26412 | $177.94 | $2,542.00 | $351.82 – $1,464.08 | 34 |
| Repair/graft kneecap tendon CPT 27381 | $201.32 | $2,876.00 | $139.24 – $1,594.59 | 34 |
| Repair/graft of foot tendon CPT 28202 | $106.47 | $1,521.00 | $50.00 – $1,099.60 | 34 |
| Repair/graft of foot tendon CPT 28210 | $103.81 | $1,483.00 | $45.00 – $991.80 | 34 |
| Repair/graft of thigh CPT 27472 | $304.99 | $4,357.00 | $969.84 – $2,550.87 | 34 |
| Repair/graft of thigh muscle CPT 27386 | $210.21 | $3,003.00 | $40.00 – $19,141.34 | 36 |
| Repair/graft of tibia CPT 27724 | $300.65 | $4,295.00 | $185.41 – $2,579.34 | 34 |
| Repair/graft radius or ulna CPT 25405 | $252.77 | $3,611.00 | $75.00 – $2,498.66 | 34 |
| Repair/graft radius & ulna CPT 25420 | $282.03 | $4,029.00 | $75.00 – $2,745.45 | 34 |
| Repair/graft wrist bone CPT 25440 | $189.21 | $2,703.00 | $590.47 – $1,592.22 | 34 |
| Repair hand joint CPT 26540 | $174.51 | $2,493.00 | $35.00 – $1,385.77 | 34 |
| Repair hand joint with graft CPT 26541 | $207.48 | $2,964.00 | $70.00 – $1,680.01 | 34 |
| Repair humerus with graft CPT 24435 | $263.76 | $3,768.00 | $30.00 – $2,085.78 | 34 |
| Repair ing hernia sliding CPT 49525 | $136.43 | $1,949.00 | $384.96 – $979.18 | 34 |
| Repair leg fascia defect CPT 27656 | $84.35 | $1,205.00 | $57.33 – $1,034.58 | 34 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $90.02 | $1,286.00 | $55.00 – $772.18 | 34 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $105.84 | $1,512.00 | $20.00 – $895.28 | 34 |
| Repair liver wound 47350 CPT 47350 | $318.99 | $4,557.00 | $30.00 – $2,502.54 | 36 |
| Repair liver wound 47360 CPT 47360 | $434.70 | $6,210.00 | $30.00 – $3,203.09 | 34 |
| Repair lower leg tendons CPT 27675 | $122.71 | $1,753.00 | $55.47 – $1,044.08 | 34 |
| Repair lumbar hernia CPT 49540 | $159.46 | $2,278.00 | $40.00 – $1,164.11 | 34 |
| Repair major blood vessel(s) without bypass 33320 CPT 33320 | $244.30 | $3,490.00 | $139.24 – $1,882.86 | 34 |
| Repair middle ear structures CPT 69667 | $197.61 | $2,823.00 | $75.00 – $1,296.55 | 34 |
| Repair muscles of hand CPT 26591 | $123.62 | $1,766.00 | $40.00 – $946.79 | 34 |
| Repair nasal septum defect CPT 30630 | $164.64 | $2,352.00 | $488.09 – $8,745.94 | 36 |
| Repair nasal stenosis CPT 30465 | $250.88 | $3,584.00 | $702.90 – $15,616.06 | 36 |
| Repair nerve add-on 64832 CPT 64832 | $77.84 | $1,112.00 | $153.02 – $873.58 | 34 |
| Repair nonunion hand CPT 26546 | $259.42 | $3,706.00 | $60.00 – $1,967.13 | 34 |
| Repair of achilles tendon CPT 27654 | $176.75 | $2,525.00 | $50.00 – $1,414.25 | 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.