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 of aneurysm CPT 35141 | $242.76 | $3,468.00 | $407.00 – $2,097.91 | 34 |
| Repair of ankle ligament CPT 27695 | $120.61 | $1,723.00 | $84.51 – $1,001.36 | 34 |
| Repair of ankle ligament CPT 27698 | $156.52 | $2,236.00 | $116.90 – $1,331.20 | 34 |
| Repair of ankle ligaments CPT 27696 | $134.96 | $1,928.00 | $516.33 – $1,200.69 | 34 |
| Repair of bladder opening CPT 51880 | $112.28 | $1,604.00 | $188.00 – $804.93 | 34 |
| Repair of bowel lesion CPT 44605 | $299.81 | $4,283.00 | $80.00 – $2,280.81 | 34 |
| Repair of circumcision CPT 54163 | $53.90 | $770.00 | $60.00 – $363.01 | 36 |
| Repair of diaphragm hernia CPT 39540 | $200.55 | $2,865.00 | $25.00 – $1,821.38 | 34 |
| Repair of digit nerve hand/foot 1 nerve CPT 64831 | $171.43 | $2,449.00 | $56.59 – $1,752.37 | 34 |
| Repair of enterocele vaginal approach 57268 CPT 57268 | $122.71 | $1,753.00 | $207.00 – $978.77 | 34 |
| Repair of eye socket wound CPT 65290 | $119.35 | $1,705.00 | $195.46 – $866.09 | 34 |
| Repair of eye wound CPT 65270 | $70.00 | $1,000.00 | $47.00 – $6,271.62 | 36 |
| Repair of eye wound CPT 65275 | $145.11 | $2,073.00 | $65.00 – $970.44 | 34 |
| Repair of eye wound CPT 65285 | $268.31 | $3,833.00 | $846.98 – $1,841.74 | 34 |
| Repair of facial nerve CPT 64864 | $207.34 | $2,962.00 | $677.96 – $2,156.57 | 34 |
| Repair of foot tendon CPT 28200 | $81.34 | $1,162.00 | $80.00 – $778.88 | 34 |
| Repair of hand or foot nerve CPT 64834 | $182.70 | $2,610.00 | $67.39 – $1,809.74 | 34 |
| Repair of hand or foot nerve CPT 64835 | $198.17 | $2,831.00 | $50.00 – $1,971.42 | 34 |
| Repair of humerus CPT 24430 | $256.48 | $3,664.00 | $716.68 – $2,028.83 | 34 |
| Repair of hydrocele 55060 CPT 55060 | $92.75 | $1,325.00 | $30.00 – $9,298.64 | 36 |
| Repair of kneecap tendon CPT 27380 | $154.14 | $2,202.00 | $92.70 – $1,172.21 | 34 |
| Repair of knee cartilage CPT 27403 | $159.25 | $2,275.00 | $40.00 – $1,271.87 | 34 |
| Repair of knee ligament CPT 27405 | $166.53 | $2,379.00 | $90.00 – $1,333.57 | 34 |
| Repair of knee ligament CPT 27407 | $195.65 | $2,795.00 | $55.00 – $1,540.01 | 34 |
| Repair of leg tendon each CPT 27658 | $92.26 | $1,318.00 | $288.53 – $771.19 | 34 |
| Repair of leg tendon each CPT 27659 | $116.69 | $1,667.00 | $25.00 – $1,020.35 | 34 |
| Repair of leg tendon each CPT 27665 | $103.60 | $1,480.00 | $63.29 – $844.75 | 34 |
| Repair of mesentery 44850 CPT 44850 | $176.89 | $2,527.00 | $96.80 – $1,280.29 | 34 |
| Repair of metatarsals CPT 28322 | $141.89 | $2,027.00 | $75.00 – $1,371.81 | 34 |
| Repair of nasal septum CPT 30520 | $166.39 | $2,377.00 | $25.00 – $8,745.94 | 36 |
| Repair of penis CPT 54440 | $151.69 | $2,167.00 | $183.54 – $968.02 | 15 |
| Repair of rectocele 45560 CPT 45560 | $165.62 | $2,366.00 | $20.00 – $1,232.51 | 34 |
| Repair of rectum CPT 45505 | $147.00 | $2,100.00 | $409.53 – $921.07 | 34 |
| Repair of ruptured spleen 38115 CPT 38115 | $299.67 | $4,281.00 | $95.00 – $2,504.69 | 34 |
| Repair of ruptured tendon CPT 24342 | $189.63 | $2,709.00 | $35.00 – $1,566.11 | 34 |
| Repair of shoulder CPT 23420 | $238.14 | $3,402.00 | $35.00 – $2,085.78 | 34 |
| Repair of thigh muscle CPT 27385 | $150.92 | $2,156.00 | $253.00 – $1,257.64 | 34 |
| Repair of tibia CPT 27720 | $213.08 | $3,044.00 | $45.00 – $19,141.34 | 36 |
| Repair of toe dislocation CPT 28675 | $103.04 | $1,472.00 | $250.93 – $751.93 | 34 |
| Repair of urethra defect CPT 53275 | $63.00 | $900.00 | $129.56 – $460.34 | 34 |
| Repair of urethra injury CPT 53505 | $117.88 | $1,684.00 | $20.00 – $823.35 | 34 |
| Repair of windpipe defect CPT 31825 | $118.44 | $1,692.00 | $25.00 – $1,021.53 | 34 |
| Repair palate pharynx/uvula CPT 42145 | $167.93 | $2,399.00 | $25.00 – $15,616.06 | 36 |
| Repair pm/icd lead dual CPT 33220 | $787.50 | $11,250.00 | $295.23 – $9,857.82 | 18 |
| Repair pm/icd lead sgl CPT 33218 | $90.93 | $1,299.00 | $210.72 – $9,857.82 | 36 |
| Repair radius or ulna CPT 25400 | $196.70 | $2,810.00 | $45.00 – $2,028.83 | 34 |
| Repair radius & ulna CPT 25415 | $235.41 | $3,363.00 | $843.26 – $2,334.93 | 34 |
| Repair rectum; remove sigmoid 45550 CPT 45550 | $343.35 | $4,905.00 | $50.00 – $2,535.70 | 34 |
| Repair rectum & vagina CPT 57250 | $147.63 | $2,109.00 | $50.00 – $1,255.03 | 34 |
| Repair rectum-vagina fistula CPT 57300 | $147.98 | $2,114.00 | $146.94 – $8,539.30 | 36 |
| Repair rectum-vagina fistula abd appr 57305 CPT 57305 | $232.19 | $3,317.00 | $890.42 – $1,820.72 | 34 |
| Repair recur fem hernia reduce 49555 CPT 49555 | $143.50 | $2,050.00 | $70.00 – $1,026.60 | 34 |
| Repair retinal detach cplx CPT 67113 | $322.07 | $4,601.00 | $234.92 – $2,465.22 | 34 |
| Repair & revise nerve add-on CPT 64874 | $40.25 | $575.00 | $65.00 – $456.35 | 34 |
| Repair/revise wrist joint CPT 25320 | $245.77 | $3,511.00 | $70.00 – $1,895.95 | 34 |
| Repair rotator cuff acute CPT 23410 | $200.55 | $2,865.00 | $70.00 – $1,796.29 | 34 |
| Repair rotator cuff chronic CPT 23412 | $208.11 | $2,973.00 | $45.00 – $1,912.56 | 34 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $78.82 | $1,126.00 | $53.24 – $668.78 | 34 |
| Repair salivary duct CPT 42500 | $85.68 | $1,224.00 | $65.00 – $640.19 | 34 |
| Repair salivary duct CPT 42505 | $112.70 | $1,610.00 | $60.00 – $852.98 | 34 |
| Repair shoulder capsule CPT 23455 | $235.41 | $3,363.00 | $40.00 – $2,038.32 | 34 |
| Repair shoulder capsule CPT 23460 | $264.04 | $3,772.00 | $168.65 – $2,202.05 | 34 |
| Repair shoulder capsule CPT 23462 | $257.95 | $3,685.00 | $70.00 – $2,152.22 | 34 |
| Repair shoulder capsule CPT 23465 | $270.55 | $3,865.00 | $70.00 – $2,240.02 | 34 |
| Repair shoulder capsule CPT 23466 | $272.30 | $3,890.00 | $70.00 – $2,192.56 | 34 |
| Repair spinal fluid leakage 63707 CPT 63707 | $225.05 | $3,215.00 | $903.24 – $2,143.53 | 34 |
| Repair stomach-bowel fistula 43880 CPT 43880 | $373.24 | $5,332.00 | $1,029.41 – $2,787.51 | 34 |
| Repair stomach opening CPT 43870 | $167.23 | $2,389.00 | $446.76 – $1,201.59 | 34 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $79.80 | $1,140.00 | $45.00 – $741.15 | 34 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | $158.48 | $2,264.00 | $373.79 – $1,611.20 | 34 |
| Repair testis injury CPT 54670 | $99.82 | $1,426.00 | $55.00 – $691.82 | 34 |
| Repair toe dislocation CPT 28645 | $120.54 | $1,722.00 | $469.58 – $961.90 | 27 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $44.66 | $638.00 | $60.00 – $355.62 | 34 |
| Repair/transpose mp nerve 64856 CPT 64856 | $241.99 | $3,457.00 | $35.00 – $2,456.45 | 34 |
| Repair upper arm/elbow tendon/muscle ea CPT 24341 | $185.92 | $2,656.00 | $60.00 – $19,141.34 | 36 |
| Repair upper jaw fistula CPT 30580 | $114.45 | $1,635.00 | $25.00 – $1,071.81 | 34 |
| Repair vagina/perineum CPT 57210 | $95.27 | $1,361.00 | $147.28 – $8,539.30 | 35 |
| Repair webbed toe(s) CPT 28345 | $89.67 | $1,281.00 | $82.65 – $962.15 | 34 |
| Repeat thyroid surgery CPT 60260 | $258.16 | $3,688.00 | $126.58 – $15,616.06 | 36 |
| Replac av w/bypas/other pros valve 33405 CPT 33405 | $482.44 | $6,892.00 | $105.00 – $4,177.52 | 34 |
| Replace duod/jej tube perc CPT 49451 | $325.01 | $4,643.00 | $35.00 – $2,392.56 | 36 |
| Replace elbow joint CPT 24363 | $348.74 | $4,982.00 | $65.00 – $2,928.16 | 34 |
| Replace g/c tube perc CPT 49450 | $325.01 | $4,643.00 | $55.55 – $2,392.56 | 36 |
| Replace g-j tube perc CPT 49452 | $286.79 | $4,097.00 | $35.00 – $2,392.56 | 36 |
| Replace picvad cath CPT 36585 | $71.68 | $1,024.00 | $287.69 – $2,038.43 | 34 |
| Replace tunneled cv cath CPT 36578 | $47.18 | $674.00 | $147.06 – $926.56 | 34 |
| Replantation thumb complete CPT 20827 | $436.10 | $6,230.00 | $40.00 – $4,845.46 | 34 |
| Reposition intraocular lens CPT 66825 | $203.91 | $2,913.00 | $101.64 – $1,372.18 | 34 |
| Reposition pm/icd lead CPT 33215 | $71.96 | $1,028.00 | $30.16 – $555.94 | 34 |
| Reposition vad w/image rt/lt sep session CPT 33993 | $37.52 | $536.00 | $37.00 – $478.15 | 34 |
| Repos lv lead pm/icd CPT 33226 | $110.95 | $1,585.00 | $85.00 – $871.65 | 34 |
| Repos sq defib eltrd CPT 33273 | $996.80 | $14,240.00 | $344.75 – $9,857.82 | 18 |
| Repr elbow lat ligmnt w/tiss CPT 24343 | $177.94 | $2,542.00 | $109.08 – $1,378.65 | 34 |
| Repr elbw med ligmnt w/tissu CPT 24345 | $176.12 | $2,516.00 | $544.67 – $1,371.54 | 34 |
| Repr of anal fistula w/glue CPT 46706 | $43.61 | $623.00 | $15.26 – $277.40 | 34 |
| Reptilase test CPT 85635 | $0.61 | $8.75 | $3.58 – $108.30 | 23 |
| Reremove wrist tendon lesion CPT 25112 | $98.77 | $1,411.00 | $210.72 – $4,241.76 | 36 |
| Rerepair fem hernia blocked CPT 49557 | $170.31 | $2,433.00 | $94.94 – $1,249.46 | 34 |
| Rerepair ing hernia blocked CPT 49521 | $169.54 | $2,422.00 | $35.00 – $1,330.07 | 34 |
| Rerepair ing hernia reduce CPT 49520 | $149.94 | $2,142.00 | $70.00 – $1,085.87 | 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.