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 |
|---|---|---|---|---|
| Arthrt elbow w/synovectomy CPT 24102 | $152.67 | $2,181.00 | $50.00 – $1,212.55 | 34 |
| Arthrt elbw capsl exc rls CPT 24006 | $176.12 | $2,516.00 | $25.00 – $1,402.38 | 34 |
| Arthrt elbw jt expl bx rmvl CPT 24101 | $125.79 | $1,797.00 | $80.04 – $975.26 | 34 |
| Arthrt gh jt expl/drg/rmv fb CPT 23040 | $176.19 | $2,517.00 | $30.00 – $1,418.99 | 34 |
| Arthrt glenhumrl jt w/expl CPT 23107 | $163.87 | $2,341.00 | $92.70 – $1,307.47 | 34 |
| Arthrt hip expl/rmv loose/fb CPT 27033 | $235.90 | $3,370.00 | $118.02 – $1,950.52 | 34 |
| Arthrt rdcrpl/midcarpl jt CPT 25040 | $138.53 | $1,979.00 | $55.00 – $1,169.84 | 34 |
| Arth shld srg decompr subacrml sp w/prt acrmplsty w/crccrml sep proc lt(rest method ii cah) CPT 29826 | $72.87 | $1,041.00 | $67.00 – $1,343.06 | 34 |
| Ascend aorta graft oth dissect 33859 CPT 33859 | $500.01 | $7,143.00 | $2,063.66 – $5,634.85 | 34 |
| Ascenda two piece catheter HCPCS C1772 | $4,591.02 | $65,586.00 | $56,000.00 – $70,000.00 | 4 |
| Ascvd rsk mng clin stf pr mo HCPCS G0538 | $2.80 | $40.00 | $40.00 – $304.00 | 17 |
| Ashkenazi jewish assoc dis CPT 81412 | $171.40 | $2,448.56 | $1,599.85 – $16,277.13 | 22 |
| Aspa gene CPT 81200 | $3.31 | $47.25 | $47.25 – $1,101.97 | 22 |
| Asp core fat pad CPT 17999 | $53.48 | $764.00 | $25.00 – $529.26 | 21 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $792.40 | $11,320.00 | $45.00 – $631.32 | 36 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $68.18 | $974.00 | $36.79 – $304.00 | 36 |
| Aspirate pleura without imaging 32554 CPT 32554 | $72.31 | $1,033.00 | $12.00 – $1,458.04 | 36 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $304.99 | $4,357.00 | $61.53 – $304.00 | 35 |
| Aspiration peritonsillar abscess CPT 42999 | $19.25 | $275.00 | $38.00 – $74.00 | 9 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $11.41 | $163.00 | $32.00 – $1,868.00 | 36 |
| Assay acid phosphatase CPT 84060 | $0.53 | $7.64 | $2.09 – $82.10 | 23 |
| Assay dir meas fr estradiol CPT 82681 | $1.96 | $27.94 | $22.35 – $104.23 | 23 |
| Assay of adp & amp CPT 82030 | $1.81 | $25.80 | $9.64 – $283.60 | 23 |
| Assay of breath ethanol CPT 82075 | $2.10 | $30.00 | $0.03 – $128.29 | 22 |
| Assay of corticosterone CPT 82528 | $1.40 | $20.02 | $8.40 – $239.48 | 23 |
| Assay of feces porphyrins CPT 84126 | $2.74 | $39.11 | $9.69 – $280.12 | 23 |
| Assay of fluoride CPT 82735 | $7.56 | $108.00 | $6.89 – $203.87 | 23 |
| Assay of glutathione CPT 82978 | $4.76 | $68.00 | $5.25 – $156.72 | 23 |
| Assay of interleukin-6 (il-6) CPT 83529 | $1.21 | $17.27 | $17.27 – $51.15 | 22 |
| Assay of leflunomide CPT 80193 | $2.70 | $38.57 | $30.86 – $143.91 | 23 |
| Assay of osteocalcin CPT 83937 | $2.32 | $33.16 | $29.85 – $128.73 | 22 |
| Assay of procainamide CPT 80190 | $4.20 | $60.00 | $6.18 – $183.59 | 23 |
| Assay of procainamide w/metab CPT 80192 | $1.17 | $16.75 | $6.18 – $183.59 | 23 |
| Assay of prostaglandin CPT 84150 | $182.00 | $2,600.00 | $9.32 – $274.42 | 23 |
| Assay of PSA complexed CPT 84152 | $1.29 | $18.39 | $4.50 – $202.09 | 23 |
| Assay of salicylate CPT 80179 | $23.38 | $334.00 | $14.91 – $69.51 | 23 |
| Assay of semen fructose CPT 82757 | $1.21 | $17.34 | $17.34 – $191.36 | 22 |
| Assay of silica CPT 84285 | $7.28 | $104.00 | $8.79 – $258.87 | 23 |
| Assay of somatostatin CPT 84307 | $13.58 | $194.00 | $6.27 – $194.54 | 23 |
| Assay of tyrosine CPT 84510 | $0.65 | $9.25 | $3.14 – $114.37 | 23 |
| Assay of urine sulfate CPT 84392 | $0.31 | $4.39 | $1.64 – $52.41 | 23 |
| Assay phosphatidylglycerol CPT 84081 | $1.16 | $16.52 | $6.11 – $175.81 | 23 |
| Assay toxin or antitoxin CPT 87230 | $6.48 | $92.60 | $7.52 – $217.12 | 23 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $49.07 | $701.00 | $73.44 – $499.00 | 24 |
| Assess care plan pt w/cog impair 99483 CPT 99483 | $49.28 | $704.00 | $133.99 – $543.51 | 36 |
| Assess cyst contrast inject CPT 49424 | $259.70 | $3,710.00 | $12.00 – $215.92 | 36 |
| Assessment leukocyte fecal qualitative/semiquantitative CPT 89055 | $0.30 | $4.27 | $4.27 – $46.93 | 24 |
| Asses tinnit/pitch/loud/match/mask 92625 CPT 92625 | $11.83 | $169.00 | $40.07 – $447.25 | 37 |
| Assist-bilat spinal disk surgery add-on 63035 CPT 63035 | $53.13 | $759.00 | $103.00 – $511.11 | 34 |
| Ast/sgot CPT 84450 | $44.73 | $639.00 | $1.68 – $56.85 | 23 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $19.95 | $284.98 | $0.15 – $407.24 | 11 |
| Attach bladder/urethra simple 51840 CPT 51840 | $167.30 | $2,390.00 | $30.00 – $1,139.01 | 34 |
| Attn at delivery+ 1 stabilization of newborn 99464 CPT 99464 | $12.67 | $181.00 | $59.20 – $304.00 | 36 |
| Audiometry air + bone CPT 92553 | $18.06 | $258.00 | $20.40 – $339.43 | 36 |
| Audit/dast 15-30 min CPT 99408 | $7.07 | $101.00 | $37.89 – $304.00 | 27 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $50.26 | $718.00 | $55.00 – $11,385.17 | 34 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $2,929.36 | $41,848.00 | $445.52 – $19,141.34 | 36 |
| Autgrft implnt knee w/scope CPT 29866 | $256.69 | $3,667.00 | $65.00 – $2,095.27 | 34 |
| Autochondrocyte implant knee CPT 27412 | $395.99 | $5,657.00 | $834.32 – $3,272.23 | 34 |
| Av fistula revision CPT 36833 | $181.58 | $2,594.00 | $109.08 – $1,210.25 | 34 |
| Av fuse uppr arm basilic CPT 36819 | $163.59 | $2,337.00 | $85.00 – $14,678.70 | 36 |
| Av fuse uppr arm cephalic CPT 36818 | $155.12 | $2,216.00 | $81.53 – $14,678.70 | 36 |
| Av fusion direct any site CPT 36821 | $148.40 | $2,120.00 | $88.61 – $8,329.20 | 36 |
| Av fusion/forearm vein 36820 CPT 36820 | $164.29 | $2,347.00 | $70.00 – $1,461.90 | 34 |
| Avul nail plate addl CPT 11732 | $13.58 | $194.00 | $14.94 – $67.69 | 36 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $64.89 | $927.00 | $32.02 – $304.00 | 36 |
| Axillary lymphadenect/superficial 38740 CPT 38740 | $166.88 | $2,384.00 | $60.00 – $1,371.18 | 34 |
| Azathioprine 50 mg tablet HCPCS J7500 | $0.94 | $13.44 | $0.14 – $62.64 | 10 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $24.47 | $349.57 | $3.00 – $499.53 | 11 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $60.61 | $865.81 | $1.67 – $1,237.24 | 8 |
| Baclofen eval charges CPT 97750 | $11.90 | $170.00 | $16.50 – $499.00 | 24 |
| Bacterial meningitis antigen CPT 86403 | $0.81 | $11.54 | $3.70 – $108.82 | 23 |
| Bacterial vaginosis pcr CPT 87801 | $31.52 | $450.28 | $10.69 – $385.68 | 23 |
| Bactericidal level serum CPT 87197 | $1.05 | $15.02 | $5.21 – $128.66 | 23 |
| #bac vag cand-c. albicans naa CPT 87481 | $19.25 | $275.00 | $12.31 – $373.39 | 23 |
| Balloon dilate urtrl strix CPT 50706 | $516.81 | $7,383.00 | $152.77 – $1,105.87 | 18 |
| Bard marquee Ultrasound biopsy device HCPCS A4649 | $2,404.08 | $34,344.00 | $38.00 – $120.00 | 11 |
| Bartholin gland cyst/marsupializat 56440 CPT 56440 | $43.75 | $625.00 | $152.00 – $381.51 | 36 |
| Bartonella dna pcr-sendout CPT 87471 | $2.18 | $31.19 | $12.31 – $373.39 | 23 |
| Basic vestibular evaluation CPT 92540 | $18.69 | $267.00 | $28.65 – $179.51 | 34 |
| Bausch health Ultrasound surg HCPCS V2788 | $99.75 | $1,425.00 | $74.00 – $588.97 | 9 |
| B cells total count CPT 86355 | $2.87 | $40.95 | $9.24 – $405.74 | 23 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $0.56 | $8.00 | $3.26 – $9.28 | 18 |
| Behavior counsel obesity 15min medicare g0447 HCPCS G0447 | $6.86 | $98.00 | $30.65 – $267.99 | 18 |
| Benign lesion paring 2-4 CPT 11056 | $23.03 | $329.00 | $7.00 – $304.00 | 36 |
| Benign lesion paring 4+ CPT 11057 | $23.03 | $329.00 | $25.22 – $304.00 | 36 |
| #_benzodiazconfur CPT 80346 | $17.01 | $243.00 | $0.03 – $186.77 | 8 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $1.78 | $25.45 | $5.63 – $279.60 | 23 |
| Beta-2 microglobulin CPT 82232 | $1.13 | $16.18 | $4.87 – $177.96 | 23 |
| Beta-amyloid 1-42 CPT 82234 | $22.40 | $320.00 | $128.92 – $257.84 | 21 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $61.88 | $884.00 | $2.47 – $25.52 | 19 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $12.60 | $180.00 | $73.20 – $208.80 | 18 |
| Bfb train 1st 15min cntct 90912 CPT 90912 | $7.28 | $104.00 | $37.69 – $207.37 | 36 |
| Bilateral laminotomy addl lumbar 63044 CPT 63044 | $70.14 | $1,002.00 | $431.32 – $1,293.42 | 15 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $36.33 | $519.00 | $12.00 – $304.00 | 36 |
| Bilateral n block inj occipital 64405 CPT 64405 | $18.13 | $259.00 | $12.00 – $304.00 | 36 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $88.20 | $1,260.00 | $12.00 – $304.00 | 36 |
| Bile duct endoscopy add-on 47550 CPT 47550 | $37.10 | $530.00 | $30.00 – $303.48 | 36 |
| Bilicheck CPT 88720 | $39.55 | $565.00 | $1.00 – $47.44 | 36 |
| Bilirubin direct CPT 82248 | $41.02 | $586.00 | $1.68 – $55.00 | 23 |
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.