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 |
|---|---|---|---|---|
| Resect back tum < 5 cm CPT 21935 | $241.78 | $3,454.00 | $167.16 – $7,662.42 | 36 |
| Resect back tum 5 cm/> CPT 21936 | $332.85 | $4,755.00 | $69.00 – $3,402.74 | 36 |
| Resect condyle distal phalanx ea toe 28153 CPT 28153 | $65.94 | $942.00 | $70.00 – $644.13 | 34 |
| Resect/debrid pancreas 48105 CPT 48105 | $105.21 | $1,503.00 | $50.00 – $4,938.58 | 34 |
| Resect diaphragm complex CPT 39561 | $294.91 | $4,213.00 | $149.29 – $2,566.39 | 34 |
| Resect distal finger tumor CPT 26262 | $156.10 | $2,230.00 | $84.51 – $887.46 | 34 |
| Resect face/scalp tum 2 cm/> CPT 21016 | $241.85 | $3,455.00 | $172.00 – $7,662.42 | 36 |
| Resect femur/knee tumor CPT 27365 | $489.09 | $6,987.00 | $205.51 – $2,767.20 | 34 |
| Resect forarm/wrist tum 3cm> CPT 25078 | $279.37 | $3,991.00 | $183.92 – $7,662.42 | 36 |
| Resect inferior turbinate CPT 30140 | $73.29 | $1,047.00 | $30.00 – $822.71 | 36 |
| Resection palate/lesion 42120 CPT 42120 | $246.33 | $3,519.00 | $30.00 – $1,664.37 | 34 |
| Resect leg/ankle tum < 5 cm CPT 27615 | $241.99 | $3,457.00 | $864.85 – $7,662.42 | 36 |
| Resect leg/ankle tum 5 cm/> CPT 27616 | $297.71 | $4,253.00 | $1,051.38 – $7,662.42 | 36 |
| Resect neck tumor 5 cm/> CPT 21558 | $317.59 | $4,537.00 | $44.00 – $7,662.42 | 36 |
| Resect part/compl phalangeal base ea 28126 CPT 28126 | $62.16 | $888.00 | $65.00 – $622.57 | 34 |
| Resect thigh/knee tum < 5 cm CPT 27329 | $248.71 | $3,553.00 | $178.33 – $7,662.42 | 36 |
| Resect thigh/knee tum 5 cm/> CPT 27364 | $372.19 | $5,317.00 | $256.89 – $7,662.42 | 36 |
| Resin three surfaces-anterio HCPCS D2332 | $35.70 | $510.00 | $152.00 – $728.79 | 17 |
| Respirator motion mgmt simul CPT 77293 | $29.61 | $423.00 | $107.76 – $459.57 | 34 |
| #resp virpnl dfa-adenovirus CPT 87260 | $1.01 | $14.43 | $3.18 – $98.83 | 23 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $1.15 | $16.43 | $2.78 – $102.08 | 23 |
| Resp virus 6-11 targets CPT 87632 | $199.99 | $2,857.00 | $42.58 – $1,778.65 | 23 |
| Resuscitation cardiopulmonary CPT 92950 | $866.46 | $12,378.00 | $115.00 – $569.59 | 36 |
| Resuscitation delivery/birthing room CPT 99465 | $290.71 | $4,153.00 | $122.00 – $404.77 | 36 |
| Reticulated platelet assay CPT 85055 | $2.00 | $28.59 | $7.88 – $295.52 | 23 |
| Reticulocyte automated CPT 85045 | $51.17 | $731.00 | $1.35 – $43.97 | 23 |
| Reticulocyte direct measurement automated CPT 85046 | $0.39 | $5.57 | $1.96 – $61.15 | 23 |
| Revasc evasc fpvt athrec cplx 1st CPT 37273 | $6,555.04 | $93,643.45 | $24,178.70 – $147,956.65 | 17 |
| Revasc evasc fpvt athrec sf 1st CPT 37271 | $6,555.01 | $93,643.00 | $45.00 – $48,357.40 | 28 |
| Revasc evasc ivt stent sf 1st CPT 37258 | $6,207.11 | $88,673.00 | $15,226.40 – $140,103.34 | 17 |
| Revasc evasc tpvt angio sf 1st CPT 37280 | $4,127.97 | $58,971.00 | $74.00 – $30,452.80 | 28 |
| Revasc intra lithotrip-ather HCPCS C9766 | $4,130.28 | $59,004.00 | $24,178.70 – $48,357.40 | 12 |
| Revasc intra lithotrip-stent HCPCS C9765 | $3,114.16 | $44,488.00 | $5,900.45 – $48,357.40 | 13 |
| Revasc intravasc lithotripsy HCPCS C9764 | $4,690.70 | $67,010.00 | $14,433.45 – $30,452.80 | 13 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $2,781.94 | $39,742.00 | $24,178.70 – $48,357.40 | 12 |
| Revasc lithotrip-stent-ather HCPCS C9767 | $3,598.91 | $51,413.00 | $24,178.70 – $48,357.40 | 12 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $4,690.70 | $67,010.00 | $15,226.40 – $30,452.80 | 12 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $3,423.98 | $48,914.00 | $24,178.70 – $48,357.40 | 12 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $2,957.85 | $42,255.00 | $24,178.70 – $48,357.40 | 12 |
| Revise arm/leg nerve CPT 64708 | $126.49 | $1,807.00 | $81.00 – $1,118.70 | 34 |
| Revise eye with implant CPT 65093 | $181.30 | $2,590.00 | $505.96 – $1,184.35 | 34 |
| Revise finger joint each CPT 26135 | $138.39 | $1,977.00 | $71.85 – $1,079.67 | 34 |
| Revise finger joint each CPT 26140 | $127.40 | $1,820.00 | $35.00 – $980.01 | 34 |
| Revise gastric port open 43886 CPT 43886 | $89.60 | $1,280.00 | $45.00 – $554.41 | 34 |
| Revise graft w/vein CPT 35879 | $205.45 | $2,935.00 | $648.17 – $1,750.17 | 34 |
| Revise graft w/vein 35881 CPT 35881 | $228.06 | $3,258.00 | $709.23 – $1,951.49 | 34 |
| Revise hand/finger tendon CPT 26390 | $216.02 | $3,086.00 | $396.87 – $1,729.84 | 34 |
| Revise hip joint replacement CPT 27134 | $452.69 | $6,467.00 | $320.18 – $3,931.90 | 34 |
| Revise hip joint replacement CPT 27138 | $363.65 | $5,195.00 | $80.00 – $3,110.87 | 34 |
| Revise hip joint replacement CPT 27137 | $350.28 | $5,004.00 | $247.58 – $2,987.48 | 34 |
| Revise/implant finger joint CPT 26536 | $187.25 | $2,675.00 | $55.00 – $1,276.62 | 34 |
| Revise kneecap CPT 27437 | $162.82 | $2,326.00 | $111.69 – $1,305.10 | 34 |
| Revise kneecap with implant CPT 27438 | $205.31 | $2,933.00 | $150.78 – $1,661.03 | 34 |
| Revise knuckle joint CPT 26530 | $135.73 | $1,939.00 | $30.00 – $1,036.96 | 34 |
| Revise knuckle with implant CPT 26531 | $157.71 | $2,253.00 | $65.00 – $1,210.18 | 34 |
| Revise low back nerve(s) CPT 64714 | $185.85 | $2,655.00 | $504.84 – $5,151.14 | 36 |
| Revise lower leg tendon CPT 27690 | $158.13 | $2,259.00 | $55.00 – $1,238.65 | 34 |
| Revise lower leg tendon CPT 27691 | $182.98 | $2,614.00 | $85.00 – $1,464.08 | 34 |
| Revise middle ear bone CPT 69660 | $225.19 | $3,217.00 | $79.00 – $1,513.96 | 34 |
| Revise middle ear bone CPT 69661 | $292.95 | $4,185.00 | $80.00 – $1,990.67 | 34 |
| Revise middle ear & mastoid CPT 69641 | $254.31 | $3,633.00 | $178.70 – $1,676.35 | 34 |
| Revise middle ear & mastoid CPT 69642 | $325.71 | $4,653.00 | $79.00 – $2,174.02 | 34 |
| Revise middle ear & mastoid CPT 69643 | $297.92 | $4,256.00 | $44.00 – $1,982.81 | 34 |
| Revise middle ear & mastoid CPT 69644 | $370.86 | $5,298.00 | $44.00 – $2,430.71 | 34 |
| Revise middle ear & mastoid CPT 69646 | $384.72 | $5,496.00 | $202.53 – $2,532.86 | 34 |
| Revise middle ear & mastoid 69645 CPT 69645 | $364.28 | $5,204.00 | $188.38 – $2,375.71 | 34 |
| Revise radius or ulna CPT 25370 | $246.96 | $3,528.00 | $505.96 – $2,356.29 | 34 |
| Revise radius & ulna CPT 25375 | $232.19 | $3,317.00 | $61.00 – $2,323.07 | 34 |
| Revise/remove sling repair CPT 57287 | $179.48 | $2,564.00 | $302.00 – $8,539.30 | 36 |
| Revise/replace knee joint CPT 27486 | $337.61 | $4,823.00 | $61.00 – $2,816.63 | 34 |
| Revise/replace knee joint CPT 27487 | $418.81 | $5,983.00 | $698.00 – $3,564.10 | 34 |
| Revise spermatic cord veins CPT 55530 | $85.89 | $1,227.00 | $35.00 – $599.75 | 34 |
| Revise spine eltrd perq aray CPT 63663 | $108.08 | $1,544.00 | $139.61 – $16,811.48 | 36 |
| Revise spine eltrd plate CPT 63664 | $211.40 | $3,020.00 | $30.00 – $2,417.34 | 34 |
| Revise stomach bowel fusion 43860 CPT 43860 | $380.52 | $5,436.00 | $80.00 – $2,847.14 | 34 |
| Revise thumb tendon CPT 26490 | $207.62 | $2,966.00 | $80.04 – $1,623.06 | 34 |
| Revise two eye muscles CPT 67312 | $161.84 | $2,312.00 | $50.00 – $1,265.22 | 34 |
| Revise ulnar nerve at wrist CPT 64719 | $101.78 | $1,454.00 | $35.00 – $949.20 | 34 |
| Revise vag graft via vagina CPT 57295 | $121.17 | $1,731.00 | $65.00 – $8,539.30 | 36 |
| Revise windpipe scar CPT 31830 | $90.72 | $1,296.00 | $45.00 – $8,745.94 | 36 |
| Revise wrist/forearm tendon CPT 25280 | $140.98 | $2,014.00 | $348.85 – $1,504.42 | 34 |
| Revise wrist joint CPT 25332 | $207.76 | $2,968.00 | $155.62 – $1,677.64 | 34 |
| Revision of arm nerve(s) CPT 64713 | $193.06 | $2,758.00 | $126.21 – $1,799.31 | 34 |
| Revision of big toe CPT 28310 | $90.93 | $1,299.00 | $215.19 – $892.08 | 34 |
| Revision of bladder neck CPT 52500 | $120.05 | $1,715.00 | $30.00 – $920.68 | 34 |
| Revision of calf tendon CPT 27687 | $112.77 | $1,611.00 | $328.74 – $937.30 | 34 |
| Revision of cervix CPT 57720 | $81.34 | $1,162.00 | $50.00 – $631.46 | 34 |
| Revision of cervix CPT 59320 | $34.93 | $499.00 | $58.00 – $334.15 | 34 |
| Revision of collar bone CPT 23480 | $200.34 | $2,862.00 | $70.00 – $1,642.05 | 34 |
| Revision of collar bone CPT 23485 | $231.21 | $3,303.00 | $548.03 – $1,931.54 | 34 |
| Revision of colostomy CPT 44340 | $150.43 | $2,149.00 | $60.00 – $9,348.08 | 36 |
| Revision of colostomy comp in-depth 44345 CPT 44345 | $248.01 | $3,543.00 | $322.41 – $1,801.88 | 34 |
| Revision of colostomy paraclt hernia 44346 CPT 44346 | $278.11 | $3,973.00 | $649.29 – $2,017.64 | 34 |
| Revision of cornea CPT 65600 | $84.42 | $1,206.00 | $297.84 – $6,271.62 | 36 |
| Revision of cranial nerve CPT 64716 | $125.30 | $1,790.00 | $398.73 – $1,249.09 | 34 |
| Revision of eyelid CPT 67961 | $111.51 | $1,593.00 | $404.08 – $6,271.62 | 36 |
| Revision of eyelid CPT 67966 | $159.53 | $2,279.00 | $57.00 – $6,271.62 | 36 |
| Revision of foot and ankle CPT 28262 | $269.50 | $3,850.00 | $649.29 – $2,422.89 | 34 |
| Revision of foot fascia 28250 CPT 28250 | $102.20 | $1,460.00 | $253.16 – $927.11 | 34 |
| Revision of foot tendon CPT 28238 | $119.21 | $1,703.00 | $65.90 – $1,183.15 | 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.