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 |
|---|---|---|---|---|
| X-ray sternum > 2 views CPT 71120 | $109.34 | $1,562.00 | $9.54 – $229.57 | 37 |
| X-ray surgical specimen CPT 76098 | $95.13 | $1,359.00 | $9.26 – $1,441.40 | 37 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $159.74 | $2,282.00 | $25.16 – $462.69 | 37 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $108.43 | $1,549.00 | $11.65 – $236.58 | 37 |
| X-ray thoracic spine 2 views CPT 72070 | $147.14 | $2,102.00 | $9.90 – $275.78 | 37 |
| X-ray thoracic spine 3 views CPT 72072 | $191.66 | $2,738.00 | $10.58 – $275.78 | 37 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $105.84 | $1,512.00 | $10.27 – $229.57 | 37 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $35.35 | $505.00 | $7.38 – $276.16 | 37 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $102.97 | $1,471.00 | $8.81 – $504.61 | 37 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $172.76 | $2,468.00 | $7.81 – $229.57 | 37 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $179.97 | $2,571.00 | $6.43 – $229.57 | 37 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $205.24 | $2,932.00 | $39.93 – $468.23 | 37 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $178.43 | $2,549.00 | $38.56 – $462.69 | 37 |
| X-ray wrist 2 views (both sides) CPT 73100 | $131.46 | $1,878.00 | $8.54 – $229.57 | 37 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $7.63 | $109.00 | $21.00 – $88.28 | 34 |
| Xtrnl ecg rec>48hr<7d CPT 93241 | $49.35 | $705.00 | $74.00 – $608.00 | 35 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $24.71 | $353.00 | $75.68 – $1,586.58 | 37 |
| Yersinia antibody CPT 86793 | $0.82 | $11.72 | $4.85 – $145.02 | 23 |
| Zika virus dna/rna amp probe CPT 87662 | $3.19 | $45.61 | $45.61 – $498.50 | 23 |
| Zika virus igm antibody CPT 86794 | $1.05 | $14.97 | $14.97 – $163.67 | 23 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $82.32 | $1,175.94 | $10.23 – $1,680.42 | 11 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $380.52 | $5,436.00 | $5.06 – $201.60 | 19 |
| Zoster vaccine-live inj CPT 90736 | $44.59 | $637.00 | $94.17 – $700.70 | 14 |
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.