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 |
|---|---|---|---|---|
| Bx pancreas pq ndl CPT 48102 | $1,325.31 | $18,933.00 | $42.00 – $4,356.78 | 36 |
| Bx perianal mass CPT 46999 | $210.07 | $3,001.00 | $38.00 – $2,453.16 | 14 |
| Bx pleura pq ndl CPT 32400 | $888.16 | $12,688.00 | $37.00 – $4,356.78 | 36 |
| Bx prst8 ndl sat sampling CPT 55706 | $91.28 | $1,304.00 | $65.00 – $673.41 | 34 |
| Bx shoulder tissues deep 23066 CPT 23066 | $92.75 | $1,325.00 | $60.00 – $7,662.42 | 36 |
| Bx shoulder tissues supf 23065 CPT 23065 | $38.92 | $556.00 | $30.00 – $4,356.78 | 36 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $125.93 | $1,799.00 | $24.93 – $138.09 | 36 |
| Bx skin punch ea sep/ addl les CPT 11105 | $74.83 | $1,069.00 | $12.00 – $116.43 | 36 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $40.74 | $582.00 | $17.00 – $102.89 | 36 |
| Bx/soft tis/forearm/wrist/superfic 25065 CPT 25065 | $63.70 | $910.00 | $77.44 – $424.75 | 36 |
| Bx soft tiss pelvis+hip area supf 27040 CPT 27040 | $84.00 | $1,200.00 | $136.63 – $628.82 | 36 |
| Bx soft tiss pelvis/hip deep 27041 CPT 27041 | $172.27 | $2,461.00 | $20.00 – $1,343.06 | 34 |
| Bx soft tissue back/flank deep 21925 CPT 21925 | $187.04 | $2,672.00 | $15.00 – $783.06 | 36 |
| Bx soft tissue back/flank supf 21920 CPT 21920 | $37.94 | $542.00 | $15.26 – $4,356.78 | 36 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | $1,855.42 | $26,506.00 | $15.00 – $4,356.78 | 36 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $256.83 | $3,669.00 | $17.00 – $304.00 | 36 |
| Bx vag mucos smpl (sep proc) CPT 57100 | $100.52 | $1,436.00 | $23.00 – $304.00 | 36 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $100.52 | $1,436.00 | $35.00 – $304.00 | 36 |
| Bx vulva or perineum/ea add lesion 56606 CPT 56606 | $9.10 | $130.00 | $24.71 – $84.20 | 36 |
| Bypass graft patency/patch CPT 35685 | $43.40 | $620.00 | $70.00 – $382.06 | 34 |
| Bypass temp external fem-fem CPT 37799 | $1,232.49 | $17,607.00 | $38.00 – $1,654.78 | 14 |
| C1 esterase inhibitor func - sendout CPT 86161 | $0.84 | $12.00 | $4.39 – $131.99 | 23 |
| Cabgsingle artery graft 33533 CPT 33533 | $386.82 | $5,526.00 | $65.00 – $3,502.62 | 34 |
| Cabgsingle coronary venous graft 33510 CPT 33510 | $282.03 | $4,029.00 | $1,742.32 – $4,029.00 | 18 |
| Cabg venous & art 1 vein graft 33517 CPT 33517 | $38.08 | $544.00 | $35.37 – $320.29 | 34 |
| Cabg venous & art 2 vein graft 33518 CPT 33518 | $83.86 | $1,198.00 | $353.51 – $707.02 | 36 |
| Cabg venous & art 3 vein graft 33519 CPT 33519 | $110.88 | $1,584.00 | $106.48 – $917.41 | 34 |
| Cabg venous & art 4 vein graft 33521 CPT 33521 | $133.14 | $1,902.00 | $60.00 – $1,123.31 | 34 |
| Cacna1a gene full gene seq CPT 81185 | $110.95 | $1,585.00 | $846.27 – $5,537.96 | 24 |
| Cadd pump refill CPT 96521 | $21.56 | $308.00 | $16.53 – $294.75 | 34 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $1,057.00 | $15,100.00 | $24.16 – $21,577.90 | 11 |
| Calcium 24 hour urine CPT 82340 | $47.88 | $684.00 | $2.30 – $66.33 | 23 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $35.41 | $505.90 | $0.04 – $392.04 | 10 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $47.25 | $675.04 | $0.07 – $363.41 | 10 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $34.58 | $494.05 | $0.11 – $706.00 | 10 |
| Calcium ionized CPT 82330 | $41.16 | $588.00 | $5.03 – $150.27 | 23 |
| Calcium total CPT 82310 | $41.02 | $586.00 | $1.68 – $56.56 | 23 |
| Calculi urinary-sendout CPT 82360 | $0.90 | $12.87 | $4.90 – $141.54 | 23 |
| Calprotectin fecal CPT 83993 | $1.70 | $24.22 | $4.81 – $215.79 | 23 |
| Campylobacter antibody CPT 86625 | $0.82 | $11.66 | $4.82 – $144.57 | 23 |
| Candida dna CPT 87480 | $1.40 | $20.05 | $7.45 – $213.35 | 23 |
| Cannabinoid synthetic 7/more CPT 80352 | $3.99 | $57.00 | $0.03 – $355.33 | 8 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $9,100.00 | $130,000.00 | $38.00 – $720.00 | 9 |
| Cap nerve 2x15mm HCPCS C1763 | $1,795.50 | $25,650.00 | $2,070.00 – $2,587.50 | 4 |
| Capsaicin 8% patch HCPCS J7336 | $579.32 | $8,276.00 | $3.42 – $9,600.16 | 18 |
| Capsular contracture release CPT 23020 | $169.96 | $2,428.00 | $92.70 – $1,362.04 | 34 |
| Capsulectomy/capsulotomy hip CPT 27036 | $247.87 | $3,541.00 | $736.78 – $1,974.25 | 34 |
| Capsulotomy; interphalangeal joint, each joint (separate proc) CPT 28272 | $62.65 | $895.00 | $75.00 – $4,241.76 | 36 |
| Capsulotomy mpj ea joint (sep proc) CPT 28270 | $83.51 | $1,193.00 | $85.00 – $8,631.30 | 36 |
| Cap trach decann 15mm HCPCS C1750 | $596.54 | $8,522.00 | $1,360.00 – $1,943.44 | 5 |
| Carbamazepine free CPT 80157 | $0.77 | $10.99 | $3.03 – $109.26 | 23 |
| Carbamazepine free -sendout CPT 80161 | $1.30 | $18.64 | $14.91 – $69.51 | 23 |
| Carbamazepine total therapeutic drug level CPT 80156 | $47.67 | $681.00 | $5.37 – $160.12 | 23 |
| Carbohydrate deficient transf - sendout CPT 82373 | $17.07 | $243.84 | $2.56 – $79.13 | 23 |
| Carbon dioxide CPT 82374 | $41.51 | $593.00 | $1.46 – $52.19 | 23 |
| Carboprost tromethamine 250 mcg/ml intramuscular solution HCPCS J0675 | $366.77 | $5,239.55 | $16.37 – $96.20 | 19 |
| Carboxyhemoglobin quantitative CPT 82375 | $15.61 | $223.00 | $4.52 – $135.54 | 23 |
| Carcinoembryonic ag (cea) CPT 82378 | $58.45 | $835.00 | $6.90 – $208.24 | 23 |
| Cardiac drug stress test CPT 93024 | $14.98 | $214.00 | $55.18 – $133.17 | 34 |
| Cardiac MRI w/stress img CPT 75559 | $37.59 | $537.00 | $74.97 – $644.40 | 34 |
| Cardiac perf planar mult/ef/wm CPT 78454 | $17.36 | $248.00 | $32.44 – $3,415.18 | 37 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | $12.67 | $181.00 | $36.48 – $3,415.18 | 37 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $735.84 | $10,512.00 | $50.05 – $3,415.18 | 37 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $39.97 | $571.00 | $12.07 – $340.05 | 37 |
| Cardiac rehabilitation op phase 2 without continous ecg monitoring CPT 93797 | $39.97 | $571.00 | $19.91 – $340.05 | 23 |
| Cardiac Stress Test CPT 93015 | $21.28 | $304.00 | $77.86 – $1,093.17 | 37 |
| Cardiolipin antibody iga CPT 86147 | $1.78 | $25.45 | $8.17 – $158.79 | 23 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $196.00 | $2,800.00 | $96.01 – $1,743.52 | 36 |
| Cardioversion/elective/internal 92961 CPT 92961 | $39.48 | $564.00 | $172.78 – $461.24 | 34 |
| Caregiver health risk assmt CPT 96161 | $1.68 | $24.00 | $3.25 – $98.84 | 36 |
| Caregiver training strategies&tq 1st 30 minutes CPT 97550 | $25.41 | $363.00 | $40.74 – $518.73 | 23 |
| Care mgmt svc bhvl hlth cond CPT 99484 | $10.01 | $143.00 | $36.70 – $181.55 | 36 |
| Car ion chnnlpath inc 10 gns CPT 81413 | $50.75 | $725.00 | $584.90 – $5,155.39 | 23 |
| Carotene CPT 82380 | $0.65 | $9.22 | $3.33 – $101.49 | 23 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $309.47 | $4,421.00 | $37.63 – $1,326.35 | 37 |
| Carpal Tunnel Release Surgery CPT 64721 | $109.55 | $1,565.00 | $63.29 – $5,151.14 | 36 |
| Car seat/bed test 60 minutes CPT 94780 | $14.28 | $204.00 | $49.26 – $367.91 | 22 |
| Car seat/bed test additional 30 minutes CPT 94781 | $5.39 | $77.00 | $7.05 – $332.00 | 22 |
| Ca screen;flexi sigmoidscope HCPCS G0104 | $9.80 | $140.00 | $0.86 – $222.46 | 32 |
| Cast sup sht arm adult fbrgl HCPCS Q4010 | $4.27 | $61.00 | $10.31 – $73.20 | 32 |
| Cataract Surgery CPT 66984 | $132.79 | $1,897.00 | $201.04 – $1,369.57 | 34 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $394.59 | $5,637.00 | $1,128.00 – $1,611.91 | 5 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $442.05 | $6,315.00 | $3,108.00 – $3,885.00 | 4 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $1,476.16 | $21,088.00 | $288.00 – $411.55 | 5 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $4,200.00 | $60,000.00 | $288.00 – $411.55 | 5 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $89.88 | $1,284.00 | $1,284.00 – $1,834.84 | 5 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $1,882.72 | $26,896.00 | $195.00 – $8,551.98 | 36 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $1,325.59 | $18,937.00 | $74.00 – $1,083.50 | 9 |
| Cath epdrl brevi-stf 12in .043 HCPCS C1755 | $522.41 | $7,463.00 | $4,125.00 – $5,894.63 | 5 |
| Catheter declot mechanical CPT 36596 | $10.78 | $154.00 | $41.04 – $272.25 | 34 |
| Catheter insert artery CPT 36625 | $24.29 | $347.00 | $59.20 – $187.60 | 34 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $2.17 | $31.00 | $4.32 – $44.30 | 19 |
| Catheter stripping venous CPT 36595 | $42.07 | $601.00 | $70.00 – $1,258.29 | 34 |
| Cath hawkone s directional HCPCS C1714 | $2,209.34 | $31,562.00 | $1,692.00 – $2,417.87 | 5 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $319.83 | $4,569.00 | $3,824.00 – $5,464.50 | 5 |
| Cathj umbilical vein dx/ther nb CPT 36510 | $12.46 | $178.00 | $10.00 – $285.98 | 34 |
| Cath left heart/lv gram CPT 93452 | $38.08 | $544.00 | $160.00 – $910.89 | 34 |
| Cath left heart transseptal punc CPT 93462 | $33.32 | $476.00 | $165.14 – $551.73 | 34 |
| Cath lt/rt pulm art CPT 36014 | $189.70 | $2,710.00 | $97.17 – $1,487.07 | 34 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $198.87 | $2,841.00 | $985.00 – $1,407.57 | 5 |
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.