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 |
|---|---|---|---|---|
| Revision of ileostomy complicated 44314 CPT 44314 | $237.16 | $3,388.00 | $30.00 – $1,737.87 | 34 |
| Revision of ileostomy; simple 44312 CPT 44312 | $142.31 | $2,033.00 | $67.39 – $1,002.89 | 34 |
| Revision of iris CPT 66761 | $57.68 | $824.00 | $40.00 – $1,450.85 | 36 |
| Revision of kidney/ureter CPT 50400 | $275.24 | $3,932.00 | $45.00 – $1,980.77 | 34 |
| Revision of knee joint CPT 27440 | $195.23 | $2,789.00 | $40.00 – $1,437.98 | 34 |
| Revision of knee joint CPT 27442 | $212.52 | $3,036.00 | $45.00 – $1,732.22 | 34 |
| Revision of knee joint CPT 27443 | $199.57 | $2,851.00 | $85.00 – $1,627.81 | 34 |
| Revision of knee joint CPT 27446 | $276.64 | $3,952.00 | $1,037.91 – $2,251.88 | 27 |
| Revision of leg vein 37780 CPT 37780 | $54.39 | $777.00 | $122.49 – $466.71 | 34 |
| Revision of nose CPT 30120 | $103.60 | $1,480.00 | $15.00 – $8,745.94 | 36 |
| Revision of penis CPT 54420 | $169.12 | $2,416.00 | $30.00 – $1,215.29 | 34 |
| Revision of penis CPT 54430 | $154.35 | $2,205.00 | $97.17 – $1,094.29 | 34 |
| Revision of penis CPT 54435 | $101.08 | $1,444.00 | $86.37 – $704.97 | 34 |
| Revision of radius CPT 25350 | $166.88 | $2,384.00 | $70.00 – $1,751.20 | 34 |
| Revision of sciatic nerve CPT 64712 | $145.18 | $2,074.00 | $443.78 – $1,296.03 | 34 |
| Revision of scrotum CPT 55175 | $89.32 | $1,276.00 | $65.00 – $602.38 | 34 |
| Revision of thigh muscles CPT 27430 | $181.93 | $2,599.00 | $65.00 – $19,141.34 | 36 |
| Revision of ulna CPT 25360 | $162.40 | $2,320.00 | $421.82 – $1,710.86 | 34 |
| Revision of unstable kneecap CPT 27420 | $183.26 | $2,618.00 | $122.11 – $1,483.06 | 34 |
| Revision of unstable kneecap CPT 27422 | $182.49 | $2,607.00 | $61.00 – $1,478.32 | 34 |
| Revision of urethra CPT 53460 | $111.09 | $1,587.00 | $48.00 – $776.00 | 34 |
| Revision open av fistula without thromb CPT 36832 | $2,362.92 | $33,756.00 | $35.00 – $14,678.70 | 36 |
| Revision/removal of kneecap CPT 27424 | $183.89 | $2,627.00 | $85.00 – $1,480.69 | 34 |
| Revis reconst shoulder joint CPT 23473 | $384.93 | $5,499.00 | $70.00 – $3,616.30 | 34 |
| Revis reconst shoulder joint CPT 23474 | $414.96 | $5,928.00 | $75.00 – $3,901.05 | 34 |
| Revj fem anast autog vn grf CPT 35884 | $273.91 | $3,913.00 | $1,057.06 – $2,438.79 | 34 |
| Revj fem anast nonautog grf CPT 35883 | $264.32 | $3,776.00 | $45.00 – $2,294.66 | 34 |
| Revj open gstr rstcv px CPT 43848 | $450.31 | $6,433.00 | $40.00 – $3,348.54 | 34 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $71.96 | $1,028.00 | $60.68 – $9,222.46 | 36 |
| Rev/rmv perph nstim eltrd ra CPT 64585 | $35.14 | $502.00 | $45.00 – $9,222.46 | 36 |
| Rev/rmv prph sac/gstr npg/r CPT 64595 | $55.44 | $792.00 | $108.34 – $9,222.46 | 36 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $47.60 | $680.00 | $20.00 – $1,109.49 | 34 |
| Rheumatoid factor qualitative CPT 86430 | $0.43 | $6.14 | $1.98 – $61.44 | 23 |
| Rheumatoid factor quantitative CPT 86431 | $2.03 | $29.00 | $1.98 – $61.44 | 23 |
| Rhinp prim lat&alr crtlge&/elvtn nsl tip CPT 30400 | $303.80 | $4,340.00 | $60.00 – $2,173.32 | 34 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $7.91 | $113.00 | $25.46 – $131.08 | 18 |
| Rho d immune globulin inj HCPCS J2790 | $145.95 | $2,085.00 | $55.97 – $276.00 | 19 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $203.61 | $2,908.71 | $0.15 – $4,156.55 | 10 |
| Risk ascvd tst once pr 12 mo HCPCS G0537 | $3.43 | $49.00 | $17.04 – $304.00 | 17 |
| Rmv anterior spine instrumentation 22855 CPT 22855 | $261.94 | $3,742.00 | $55.00 – $2,175.95 | 34 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $35.14 | $502.00 | $17.00 – $304.00 | 36 |
| Rmvl esophgl sphnctr dev CPT 43285 | $158.48 | $2,264.00 | $130.00 – $1,552.79 | 34 |
| Rmvl ext fixj sys under anes CPT 20694 | $85.40 | $1,220.00 | $44.00 – $873.23 | 34 |
| Rmvl fb upr arm/elbow deep CPT 24201 | $100.38 | $1,434.00 | $383.47 – $7,662.42 | 36 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | $55.86 | $798.00 | $205.88 – $3,156.66 | 36 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $55.65 | $795.00 | $43.00 – $393.90 | 36 |
| Rmvl icd by tv extr CPT 33244 | $198.94 | $2,842.00 | $55.00 – $1,557.99 | 34 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | $89.60 | $1,280.00 | $313.48 – $1,018.07 | 34 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $11,224.06 | $160,343.65 | $60.00 – $82,801.40 | 36 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $86.31 | $1,233.00 | $95.00 – $981.47 | 34 |
| Rmvl icd pulse gen only CPT 33241 | $50.61 | $723.00 | $150.04 – $418.67 | 34 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $37.38 | $534.00 | $37.00 – $1,654.78 | 36 |
| Rmvl ninfct mesh hernia rpr 49623 CPT 49623 | $46.48 | $664.00 | $11.00 – $293.55 | 33 |
| Rmvl perm pm pulse gen CPT 33233 | $55.16 | $788.00 | $50.00 – $446.12 | 34 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | $86.45 | $1,235.00 | $301.56 – $981.47 | 34 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | $78.75 | $1,125.00 | $85.00 – $905.97 | 34 |
| Rmvl pq iabp CPT 33968 | $7.63 | $109.00 | $28.33 – $66.00 | 34 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $42.07 | $601.00 | $15.00 – $546.78 | 36 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | $303.10 | $4,330.00 | $40.00 – $1,685.55 | 34 |
| Rmvl sq defib electrode CPT 33272 | $572.04 | $8,172.00 | $316.08 – $9,857.82 | 18 |
| Rmvl subq card rhythm mntr CPT 33286 | $253.96 | $3,628.00 | $23.08 – $336.31 | 36 |
| Rmvl tot arthrp 1ntrspc crv CPT 22864 | $478.52 | $6,836.00 | $273.27 – $3,303.08 | 34 |
| Rmvl tv pm lead dual CPT 33235 | $2,009.49 | $28,707.00 | $323.53 – $9,857.82 | 36 |
| Rmvl tv pm lead sgl CPT 33234 | $112.14 | $1,602.00 | $80.00 – $878.52 | 34 |
| Rmv prosth mat/mesh/abd wall/infec 11008 CPT 11008 | $61.95 | $885.00 | $20.00 – $463.42 | 36 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $1,209.04 | $17,272.00 | $5.15 – $32.97 | 23 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $18.73 | $267.53 | $0.05 – $39.60 | 19 |
| Routine footcare pt w lops HCPCS G0247 | $15.12 | $216.00 | $152.00 – $308.66 | 17 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $357.21 | $5,103.00 | $56.22 – $4,152.50 | 36 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $9.24 | $132.00 | $33.62 – $308.65 | 34 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $18.41 | $263.00 | $37.52 – $579.70 | 34 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $1,831.69 | $26,167.00 | $53.30 – $7,544.37 | 37 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $344.61 | $4,923.00 | $50.12 – $4,152.50 | 36 |
| Rpl tun-cvad w subq port CPT 36582 | $1,242.43 | $17,749.00 | $70.00 – $8,329.20 | 36 |
| Rpl tun cvc wo subq port CPT 36581 | $1,037.89 | $14,827.00 | $164.12 – $8,329.20 | 36 |
| Rpr aa hrn 1st > 10 ncr/strn CPT 49596 | $236.32 | $3,376.00 | $74.00 – $1,517.03 | 33 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | $178.29 | $2,547.00 | $74.00 – $1,142.63 | 33 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | $171.78 | $2,454.00 | $74.00 – $1,105.30 | 33 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | $132.23 | $1,889.00 | $74.00 – $850.41 | 33 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $79.38 | $1,134.00 | $74.00 – $9,444.82 | 35 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | $109.90 | $1,570.00 | $74.00 – $705.75 | 33 |
| Rpr aa hrn rcr > 10 ncr/strn CPT 49618 | $286.30 | $4,090.00 | $74.00 – $1,837.03 | 33 |
| Rpr aa hrn rcr > 10 rdc CPT 49617 | $204.96 | $2,928.00 | $74.00 – $1,313.33 | 33 |
| Rpr aa hrn rcr 3-10 ncr/strn CPT 49616 | $197.61 | $2,823.00 | $74.00 – $1,272.21 | 33 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | $147.49 | $2,107.00 | $74.00 – $948.82 | 33 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | $131.88 | $1,884.00 | $74.00 – $848.23 | 33 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | $97.58 | $1,394.00 | $74.00 – $627.25 | 33 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | $230.02 | $3,286.00 | $45.00 – $14,678.70 | 36 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | $207.48 | $2,964.00 | $70.00 – $14,678.70 | 36 |
| Rpr blvsl vn grf intra-abdl CPT 35251 | $389.62 | $5,566.00 | $75.00 – $3,079.38 | 34 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | $264.39 | $3,777.00 | $223.38 – $2,628.56 | 34 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | $217.70 | $3,110.00 | $716.68 – $1,960.79 | 34 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | $199.29 | $2,847.00 | $714.82 – $1,789.39 | 34 |
| Rpr fem hernia init blocked CPT 49553 | $150.08 | $2,144.00 | $65.00 – $9,444.82 | 36 |
| Rpr ing hernia init blocked CPT 49501 | $144.20 | $2,060.00 | $65.00 – $1,014.75 | 34 |
| Rpr ing hernia init reduce CPT 49500 | $100.31 | $1,433.00 | $70.00 – $675.71 | 34 |
| Rpr nsl vlv collapse w/implt CPT 30468 | $40.67 | $581.00 | $25.00 – $15,616.06 | 36 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | $36.05 | $515.00 | $74.00 – $15,616.06 | 28 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | $174.16 | $2,488.00 | $74.00 – $1,106.06 | 26 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | $215.95 | $3,085.00 | $74.00 – $1,364.37 | 33 |
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.