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 |
|---|---|---|---|---|
| Bone/skin graft iliac crest CPT 20970 | $677.53 | $9,679.00 | $45.00 – $5,656.99 | 34 |
| Bone survey-lead poisoning CPT 77074 | $5.74 | $82.00 | $21.00 – $68.58 | 34 |
| Boot cast sandal rocker med HCPCS L3265 | $3.15 | $45.00 | $8.66 – $54.00 | 15 |
| Boot j walker l HCPCS L4386 | $60.41 | $863.00 | $85.13 – $540.56 | 34 |
| Boot mlti podous univ xlg HCPCS L4396 | $33.95 | $485.00 | $89.95 – $562.60 | 34 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $63.70 | $910.00 | $155.62 – $1,055.60 | 34 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $12.81 | $183.00 | $6.28 – $177.15 | 23 |
| Bowel imaging CPT 78290 | $294.07 | $4,201.00 | $31.56 – $1,054.57 | 37 |
| Bpg axillary-pop/-tibial CPT 35623 | $291.34 | $4,162.00 | $50.00 – $2,560.05 | 36 |
| Bpg carotid-vertebral CPT 35642 | $220.85 | $3,155.00 | $171.26 – $1,926.33 | 34 |
| Bpg ilio-celiac CPT 35632 | $398.72 | $5,696.00 | $1,413.62 – $3,582.69 | 34 |
| Bpg ilio-mesenteric CPT 35633 | $436.73 | $6,239.00 | $1,526.06 – $3,875.53 | 34 |
| Bpg iliorenal CPT 35634 | $390.32 | $5,576.00 | $95.00 – $3,507.20 | 34 |
| Bpg pop-tibl/-prnl artery CPT 35671 | $251.72 | $3,596.00 | $193.60 – $2,113.93 | 34 |
| Bpg subclavian-axillary CPT 35616 | $244.02 | $3,486.00 | $941.26 – $2,072.75 | 34 |
| Bpg subclavian-vertebral CPT 35645 | $210.70 | $3,010.00 | $171.26 – $1,880.57 | 34 |
| Brace afo lg left 6607 HCPCS L1930 | $113.96 | $1,628.00 | $189.96 – $724.90 | 17 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $31.64 | $452.00 | $67.59 – $524.32 | 32 |
| Brace ank air stirrup univ HCPCS L4350 | $26.53 | $379.00 | $50.24 – $389.76 | 34 |
| Brace ankle stablizing lg HCPCS L1902 | $18.06 | $258.00 | $44.87 – $309.60 | 34 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $84.63 | $1,209.00 | $220.78 – $1,402.44 | 32 |
| Brace knee extender plus 22-30in HCPCS L1832 | $143.15 | $2,045.00 | $341.71 – $2,372.20 | 32 |
| Brace knee hing pat open med HCPCS L1820 | $31.22 | $446.00 | $72.88 – $517.36 | 32 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $82.88 | $1,184.00 | $122.20 – $776.04 | 28 |
| Brace wrist classic lft sm HCPCS L3908 | $15.40 | $220.00 | $32.95 – $255.20 | 34 |
| Brachioplasty 15836 CPT 15836 | $195.09 | $2,787.00 | $65.00 – $1,120.95 | 34 |
| Brach/thor cath 1st CPT 36215 | $432.25 | $6,175.00 | $90.00 – $2,054.44 | 36 |
| Brach/thor cath 2nd CPT 36216 | $428.68 | $6,124.00 | $15.00 – $2,226.03 | 36 |
| Brach/thor cath 3rd CPT 36217 | $76.09 | $1,087.00 | $80.00 – $3,868.67 | 34 |
| Brach/thor cath addl CPT 36218 | $11.90 | $170.00 | $20.00 – $377.49 | 34 |
| Brachytx isodose complex CPT 77318 | $42.91 | $613.00 | $156.85 – $376.07 | 34 |
| Braf gene CPT 81210 | $12.28 | $175.40 | $107.35 – $511.08 | 23 |
| Brain flow imaging only CPT 78610 | $3.78 | $54.00 | $13.87 – $234.32 | 34 |
| Brain image w/flow < 4 views CPT 78601 | $476.42 | $6,806.00 | $89.81 – $2,240.18 | 24 |
| Brain image w/flow 4 + views CPT 78606 | $748.51 | $10,693.00 | $29.29 – $1,432.31 | 37 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $949.62 | $13,566.00 | $47.14 – $6,337.74 | 37 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $816.20 | $11,660.00 | $31.34 – $3,223.14 | 37 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $784.98 | $11,214.00 | $31.53 – $3,223.14 | 37 |
| Brain MRI (with and without contrast) CPT 70553 | $902.72 | $12,896.00 | $59.96 – $6,172.18 | 37 |
| Brain MRI (with contrast) CPT 70552 | $868.14 | $12,402.00 | $46.77 – $3,754.20 | 37 |
| Brain MRI (without contrast) CPT 70551 | $854.49 | $12,207.00 | $38.72 – $3,134.13 | 37 |
| Brca1 dna gene analy known fam var CPT 81215 | $26.27 | $375.25 | $102.46 – $3,340.47 | 23 |
| Brca2 dna gene analy known fam var CPT 81217 | $26.27 | $375.25 | $102.46 – $3,340.47 | 23 |
| Brcassure comprehensive panel-sendout CPT 81162 | $113.55 | $1,622.11 | $1,622.11 – $26,591.02 | 23 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $629.86 | $8,998.00 | $47.00 – $1,530.47 | 36 |
| Breast punct aspir cyst, bil CPT 19000 | $256.83 | $3,669.00 | $35.00 – $304.00 | 36 |
| Breast reconstruction 19357 CPT 19357 | $284.48 | $4,064.00 | $60.00 – $36,353.20 | 36 |
| Breast reconstruction tram flap 19367 CPT 19367 | $425.74 | $6,082.00 | $95.00 – $3,738.10 | 34 |
| Breast reduction CPT 19318 | $396.69 | $5,667.00 | $197.32 – $2,365.48 | 34 |
| Breath hydrogen test 91065 CPT 91065 | $1.61 | $23.00 | $9.90 – $569.59 | 37 |
| Breath recording infant CPT 94772 | $106.12 | $1,516.00 | $62.83 – $984.36 | 23 |
| Breath tst attain/anal c-14 CPT 78267 | $0.77 | $11.06 | $11.06 – $133.90 | 23 |
| Brief alcohol misuse counsel HCPCS G0443 | $5.67 | $81.00 | $1.71 – $267.99 | 34 |
| Brief chkin, 5-10, non-e/m HCPCS G2251 | $2.52 | $36.00 | $10.87 – $74.00 | 34 |
| Brief chkin by md/qhp, 11-20 HCPCS G2252 | $4.55 | $65.00 | $22.46 – $74.40 | 34 |
| Brief comunicaj tech-bsd svc CPT 98016 | $2.87 | $41.00 | $13.11 – $74.00 | 28 |
| Bronch/asp/tracheobronch tree/subs 31646 CPT 31646 | $33.53 | $479.00 | $15.00 – $470.94 | 34 |
| Bronchial allergy tests CPT 95070 | $9.59 | $137.00 | $36.69 – $650.12 | 37 |
| Bronchial challenge CPT 94070 | $11.34 | $162.00 | $29.36 – $984.36 | 37 |
| Bronchoscopy clear airways 31645 CPT 31645 | $34.51 | $493.00 | $10.00 – $523.35 | 34 |
| Bronchoscopy/lung bx addl 31632 CPT 31632 | $11.34 | $162.00 | $40.00 – $123.41 | 34 |
| Bronchoscopy/lung bx each 31628 CPT 31628 | $41.16 | $588.00 | $158.58 – $601.71 | 34 |
| Bronchoscopy/needle bx each 31629 CPT 31629 | $43.68 | $624.00 | $168.11 – $961.34 | 34 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | $36.47 | $521.00 | $140.51 – $4,695.24 | 36 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | $41.02 | $586.00 | $10.00 – $4,695.24 | 36 |
| Br punct aspir ea add, l CPT 19001 | $9.52 | $136.00 | $17.75 – $48.04 | 36 |
| Brst rcnstj free flap CPT 19364 | $973.21 | $13,903.00 | $341.40 – $5,732.98 | 34 |
| Budesonide non-comp unit HCPCS J7626 | $4.48 | $64.00 | $0.36 – $25.20 | 19 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $9.89 | $141.23 | $0.51 – $117.21 | 10 |
| Bundled special stain group 1 microorganisms CPT 88312 | $5.25 | $75.00 | $11.27 – $269.56 | 24 |
| Bundled special stain group 2 CPT 88313 | $5.25 | $75.00 | $28.78 – $350.97 | 24 |
| Bundle his recording CPT 93600 | $18.76 | $268.00 | $110.97 – $219.18 | 34 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $15.32 | $218.84 | $0.02 – $153.53 | 10 |
| Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 | $3.18 | $45.38 | $0.01 – $64.84 | 9 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $9.30 | $132.86 | $0.01 – $189.86 | 11 |
| Buprenorphine and metabolite - sendout CPT 80348 | $4.39 | $62.74 | $0.03 – $197.95 | 8 |
| Buprenorphine oral 1mg HCPCS J0571 | $8.79 | $125.63 | $0.01 – $51.99 | 11 |
| Bur rotalink 2.15mm HCPCS C1724 | $1,546.51 | $22,093.00 | $19,500.00 – $27,865.50 | 5 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $18.69 | $267.00 | $3.16 – $12.00 | 19 |
| Buttock fasciotomy CPT 27027 | $213.78 | $3,054.00 | $90.00 – $1,677.64 | 34 |
| Buttock fasciotomy w/dbrdmt CPT 27057 | $243.32 | $3,476.00 | $720.03 – $1,865.10 | 34 |
| Bx bone trocar/ndl deep CPT 20225 | $883.82 | $12,626.00 | $112.93 – $4,356.78 | 35 |
| Bx breast 1st lesion mr imag CPT 19085 | $42.21 | $603.00 | $35.00 – $2,342.60 | 34 |
| Bx breast 1st lesion strtctc CPT 19081 | $184.03 | $2,629.00 | $47.00 – $1,537.33 | 36 |
| Bx breast add lesion strtctc CPT 19082 | $141.40 | $2,020.00 | $68.72 – $1,269.67 | 36 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $138.74 | $1,982.00 | $12.00 – $1,253.66 | 36 |
| Bx breast perq without image 19100 CPT 19100 | $53.90 | $770.00 | $34.00 – $304.00 | 36 |
| Bx breast pq tomo guide CPT 19499 | $30.73 | $439.00 | $38.00 – $74.00 | 2 |
| Bx/curett of cervix w/scope 57454 CPT 57454 | $40.81 | $583.00 | $86.14 – $328.89 | 36 |
| Bx/exc lymph node/open/deep cervic 38510 CPT 38510 | $127.82 | $1,826.00 | $14.00 – $877.56 | 36 |
| Bx/exc lymph node/open/superfic 38500 CPT 38500 | $81.55 | $1,165.00 | $96.05 – $514.19 | 36 |
| Bx/exc xdrl spine lesn crvl CPT 63275 | $418.81 | $5,983.00 | $1,458.30 – $4,258.37 | 34 |
| Bx/exc xdrl spine lesn lmbr CPT 63277 | $366.24 | $5,232.00 | $40.00 – $3,736.83 | 34 |
| Bx/exc xdrl spine lesn thrc CPT 63276 | $416.15 | $5,945.00 | $75.00 – $4,245.34 | 34 |
| Bx leg/ankle soft tissue deep 27614 CPT 27614 | $101.78 | $1,454.00 | $262.47 – $1,041.70 | 34 |
| Bx liver with other CPT 47001 | $23.66 | $338.00 | $26.00 – $192.04 | 36 |
| Bx muscle CPT 20200 | $53.06 | $758.00 | $16.00 – $358.31 | 36 |
| Bx nasopharynx/unknown pri lesion 42806 CPT 42806 | $35.28 | $504.00 | $27.92 – $360.10 | 34 |
| Bx of breast open 19101 CPT 19101 | $116.48 | $1,664.00 | $50.00 – $454.96 | 36 |
| Bx of cervix w/scope leep 57460 CPT 57460 | $367.08 | $5,244.00 | $55.00 – $676.19 | 36 |
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.