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 |
|---|---|---|---|---|
| Tendon transfer with graft CPT 26492 | $228.97 | $3,271.00 | $61.00 – $1,791.54 | 34 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $7,631.82 | $109,026.00 | $28.04 – $155,798.15 | 22 |
| Tenodesis biceps tdn at elbw CPT 24340 | $150.01 | $2,143.00 | $30.00 – $1,210.18 | 34 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | $151.90 | $2,170.00 | $27.00 – $1,274.25 | 34 |
| Tenosynovectomy radic 26145 CPT 26145 | $129.36 | $1,848.00 | $60.00 – $994.25 | 34 |
| Tenotomy hip flexor open CPT 27005 | $177.03 | $2,529.00 | $65.90 – $1,452.21 | 34 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $93.73 | $1,339.00 | $70.00 – $630.65 | 36 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $9.82 | $140.26 | $2.76 – $200.44 | 11 |
| Test for chlorohydrocarbons CPT 82441 | $8.19 | $117.00 | $1.89 – $66.03 | 23 |
| Testicular imaging w/vasc flow CPT 78761 | $9.31 | $133.00 | $33.31 – $255.48 | 34 |
| Test stress cardiovascular tracing only CPT 93017 | $210.28 | $3,004.00 | $42.46 – $569.59 | 36 |
| Tetanus ig im CPT 90389 | $177.03 | $2,529.00 | $718.49 – $3,034.80 | 16 |
| Theophylline therapeutic drug level CPT 80198 | $42.91 | $613.00 | $5.22 – $155.60 | 23 |
| Therapeutic procd strg endur HCPCS G0237 | $12.53 | $179.00 | $16.63 – $499.00 | 24 |
| Therapeutic pulpotomy HCPCS D3220 | $19.53 | $279.00 | $152.00 – $398.69 | 17 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $6.72 | $96.00 | $27.33 – $58.54 | 36 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $5.88 | $84.00 | $22.79 – $52.36 | 36 |
| Ther fx nasal inf turbinate CPT 30930 | $29.54 | $422.00 | $40.00 – $8,745.94 | 36 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $27.79 | $397.00 | $105.31 – $176.79 | 27 |
| Ther/proph/diag inj ia CPT 96373 | $3.43 | $49.00 | $15.90 – $38.07 | 34 |
| Ther radiology tx plng cplx CPT 77263 | $47.11 | $673.00 | $144.24 – $1,415.28 | 37 |
| Ther radiology tx plng intrm CPT 77262 | $30.38 | $434.00 | $92.79 – $190.41 | 34 |
| Ther radiology tx plng smpl CPT 77261 | $19.74 | $282.00 | $61.12 – $126.71 | 34 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $17.94 | $256.35 | $0.47 – $18.00 | 19 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $380.38 | $5,434.00 | $32.00 – $1,622.56 | 36 |
| Thoracic lymphadenect/thoracotomy 38746 CPT 38746 | $47.74 | $682.00 | $109.00 – $582.75 | 36 |
| Thoracoscopy diagnostic 32601 CPT 32601 | $70.14 | $1,002.00 | $40.00 – $694.73 | 34 |
| Thoracoscopy lymph node exc CPT 32674 | $47.81 | $683.00 | $174.98 – $459.35 | 36 |
| Thoracoscopy remove cortex CPT 32651 | $251.37 | $3,591.00 | $40.00 – $2,273.87 | 36 |
| Thoracoscopy remov fb/fibrin 32653 CPT 32653 | $244.16 | $3,488.00 | $484.36 – $2,203.03 | 34 |
| Thoracoscopy surgical 32650 CPT 32650 | $155.61 | $2,223.00 | $40.00 – $1,524.30 | 36 |
| Thoracoscopy/tot pulm decortication32652 CPT 32652 | $358.40 | $5,120.00 | $35.00 – $3,430.24 | 34 |
| Thoracoscopy w/bx med space CPT 32606 | $104.51 | $1,493.00 | $15.00 – $15,947.64 | 36 |
| Thoracoscopy w/pleurectomy 32656 CPT 32656 | $29.75 | $425.00 | $40.00 – $1,835.10 | 34 |
| Thoracoscopy w/wedge resect CPT 32666 | $200.76 | $2,868.00 | $35.00 – $1,912.80 | 36 |
| Thoracoscopy w w resect diag 32668 CPT 32668 | $34.86 | $498.00 | $128.07 – $335.94 | 34 |
| Thorax spine fusion CPT 22610 | $305.69 | $4,367.00 | $105.00 – $2,406.12 | 34 |
| Thorax stereo rad targetw/tx CPT 32701 | $47.46 | $678.00 | $40.00 – $461.63 | 34 |
| Thorcscpy w/biop pleura CPT 32609 | $58.52 | $836.00 | $35.00 – $15,947.64 | 36 |
| Thrcspy w/diag bp lng inf uni CPT 32607 | $70.00 | $1,000.00 | $40.00 – $28,040.80 | 36 |
| Thrcspy w/diag bp lng nod uni CPT 32608 | $85.75 | $1,225.00 | $311.24 – $28,040.80 | 36 |
| Thrombectmy crnry perq mechanical CPT 92973 | $1,085.07 | $15,501.00 | $77.33 – $321.63 | 36 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $1,848.91 | $26,413.00 | $311.01 – $15,013.92 | 36 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $3,043.04 | $43,472.00 | $375.52 – $30,452.80 | 36 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $5,244.05 | $74,915.00 | $20.00 – $48,357.40 | 36 |
| Thromb/endar/neck inc/car/vert/subc35301 CPT 35301 | $251.23 | $3,589.00 | $40.00 – $1,972.08 | 36 |
| Thrombin time CPT 85670 | $5.65 | $80.72 | $2.02 – $63.59 | 23 |
| Thromboendarterectomy common femoral CPT 35371 | $181.44 | $2,592.00 | $304.00 – $1,560.28 | 36 |
| Thromboendarterectomy including patch graft if preformed; CPT 35321 | $203.35 | $2,905.00 | $785.17 – $1,681.53 | 34 |
| Thromboendarterectomy including patch graft; iliac 35351 CPT 35351 | $285.95 | $4,085.00 | $75.00 – $2,415.92 | 34 |
| Thromboendarterectomy sfa CPT 35302 | $247.87 | $3,541.00 | $416.00 – $2,045.29 | 36 |
| Thromboplastin inhibition CPT 85705 | $9.10 | $130.00 | $3.06 – $93.27 | 23 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $63.28 | $904.00 | $2.29 – $71.14 | 23 |
| Thumb fusion with graft CPT 26820 | $205.52 | $2,936.00 | $61.00 – $1,639.67 | 34 |
| Thyroglobulin antibody CPT 86800 | $14.91 | $213.00 | $4.12 – $174.85 | 23 |
| Thyroidectomy inc substrnl split/trans approch 60270 CPT 60270 | $320.46 | $4,578.00 | $50.00 – $2,888.62 | 36 |
| Thyroid imaging CPT 78013 | $4.69 | $67.00 | $16.98 – $207.33 | 34 |
| Thyroid met imaging CPT 78015 | $8.75 | $125.00 | $31.58 – $263.37 | 34 |
| Thyroid mets imag whole body CPT 78018 | $10.64 | $152.00 | $38.77 – $400.22 | 34 |
| Thyroid (TSH) Test CPT 84443 | $44.87 | $641.00 | $6.22 – $184.77 | 23 |
| Thyroid Ultrasound CPT 76536 | $231.21 | $3,303.00 | $26.91 – $402.88 | 37 |
| Thyroid uptake measurement CPT 78012 | $249.20 | $3,560.00 | $8.83 – $1,054.57 | 37 |
| Thyroxine binding globulin (tbg) CPT 84442 | $1.03 | $14.78 | $5.45 – $151.90 | 23 |
| Tibial arthroscopy/surgery CPT 29855 | $191.17 | $2,731.00 | $638.12 – $1,573.23 | 34 |
| Tibial arthroscopy/surgery CPT 29856 | $241.08 | $3,444.00 | $136.63 – $2,012.22 | 34 |
| Tissue culture placenta CPT 88235 | $12.29 | $175.50 | $107.62 – $1,214.04 | 24 |
| Tissue culture skin/biopsy CPT 88233 | $16.71 | $238.65 | $140.73 – $1,313.61 | 24 |
| Tissue culture tumor CPT 88239 | $10.33 | $147.52 | $147.52 – $1,569.67 | 24 |
| Tissue exam koh skin/hair/nails CPT 87220 | $12.81 | $183.00 | $0.73 – $42.24 | 36 |
| Tissue transglutaminase iga CPT 86364 | $0.84 | $12.00 | $11.53 – $34.13 | 22 |
| Tlh uterus 250 g or less CPT 58570 | $193.34 | $2,762.00 | $136.30 – $2,083.83 | 34 |
| Tlh uterus over 250 g CPT 58572 | $248.08 | $3,544.00 | $130.00 – $2,581.11 | 34 |
| Tlh w/t/o 250 g or less CPT 58571 | $217.28 | $3,104.00 | $497.00 – $28,040.80 | 36 |
| Tlh w/t/o uterus over 250 g CPT 58573 | $290.01 | $4,143.00 | $956.65 – $2,907.37 | 34 |
| Tmvr w/prosthetic ring 33426 CPT 33426 | $490.56 | $7,008.00 | $115.00 – $4,239.29 | 34 |
| Tmvr w/rad reconst w or without ring 33427 CPT 33427 | $516.46 | $7,378.00 | $381.24 – $4,518.41 | 34 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $5.23 | $74.67 | $3.77 – $106.70 | 11 |
| Tobramycin peak therapeutic drug level CPT 80200 | $49.49 | $707.00 | $5.96 – $177.22 | 23 |
| Tomosynthesis breast diagnostic left HCPCS G0279 | $4.90 | $70.00 | $14.31 – $57.02 | 32 |
| Tomosynthesis breast screen bilateral CPT 77063 | $7.84 | $112.00 | $28.27 – $84.24 | 34 |
| Tongue and neck surgery CPT 41135 | $522.27 | $7,461.00 | $219.28 – $3,767.36 | 34 |
| Tongue base vol reduction CPT 41530 | $94.08 | $1,344.00 | $60.00 – $8,338.46 | 34 |
| Tongue biopsy; posterior one-third 41105 CPT 41105 | $46.90 | $670.00 | $50.00 – $304.00 | 36 |
| Tonsillectomy (age 12+) CPT 42826 | $63.49 | $907.00 | $50.00 – $8,745.94 | 36 |
| Tonsillectomy (child under 12) CPT 42825 | $66.92 | $956.00 | $168.65 – $15,616.06 | 36 |
| Total hip arthroplasty CPT 27132 | $399.63 | $5,709.00 | $100.00 – $3,367.15 | 34 |
| Total Hip Replacement CPT 27130 | $308.07 | $4,401.00 | $297.84 – $2,871.21 | 34 |
| Total hysterectomy CPT 58150 | $242.83 | $3,469.00 | $162.14 – $2,062.78 | 34 |
| Total Knee Replacement CPT 27447 | $307.72 | $4,396.00 | $435.00 – $3,089.52 | 34 |
| Total ob care failed vbac 59618 CPT 59618 | $628.88 | $8,984.00 | $90.00 – $3,631.02 | 33 |
| Total tau CPT 84394 | $21.00 | $300.00 | $128.92 – $257.84 | 21 |
| Tot disc arthrp 1ntrspc crv CPT 22856 | $381.50 | $5,450.00 | $872.00 – $3,001.72 | 34 |
| Tot disc arthrp 1ntrspc lmbr CPT 22857 | $417.20 | $5,960.00 | $185.41 – $2,961.38 | 34 |
| Tot disc arthrp ant appr disc 2nd level cervi 22858 CPT 22858 | $115.85 | $1,655.00 | $84.51 – $1,086.79 | 34 |
| Toxoplasma antibody igg CPT 86777 | $14.70 | $210.00 | $4.23 – $157.75 | 23 |
| Toxoplasma antibody igm CPT 86778 | $1.01 | $14.41 | $4.23 – $163.75 | 23 |
| Tp53 gene full gene sequence CPT 81351 | $67.90 | $970.00 | $142.00 – $2,394.70 | 23 |
| Tp53 gene trgt sequence alys CPT 81352 | $23.10 | $330.00 | $263.61 – $1,229.37 | 23 |
| Tpmt gene com vrnts CPT 81335 | $12.95 | $185.00 | $139.85 – $1,375.57 | 23 |
| Tprnl balo cntnc dev adjmt CPT 53454 | $6.16 | $88.00 | $28.52 – $659.08 | 26 |
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.