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 |
|---|---|---|---|---|
| Cath place 1st order venous 36011 CPT 36011 | $295.05 | $4,215.00 | $45.00 – $1,892.01 | 36 |
| Cath place cardio brachytx CPT 92974 | $1,284.43 | $18,349.00 | $131.66 – $294.96 | 36 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $946.33 | $13,519.00 | $392.33 – $8,551.98 | 36 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $946.33 | $13,519.00 | $296.09 – $8,551.98 | 36 |
| Cath plc art/grft/angio right hrt CPT 93457 | $1,076.25 | $15,375.00 | $332.93 – $8,551.98 | 36 |
| Cath right heart w/o2 sat & card CPT 93451 | $946.33 | $13,519.00 | $126.55 – $8,551.98 | 36 |
| Cath right hrt mnpul art CPT 36013 | $124.81 | $1,783.00 | $80.00 – $1,535.11 | 36 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $187.60 | $2,680.00 | $10.00 – $302.58 | 36 |
| Cath stripping venous s&i CPT 75901 | $6.02 | $86.00 | $22.51 – $207.41 | 34 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $63.77 | $911.00 | $479.00 – $684.49 | 5 |
| Cauterization chemical granulation tissue CPT 17250 | $57.54 | $822.00 | $3.00 – $304.00 | 36 |
| Cauterization of cervix 57510 CPT 57510 | $27.02 | $386.00 | $6.00 – $8,539.30 | 36 |
| #cbg+cort-cbg CPT 84449 | $7.35 | $105.00 | $18.00 – $170.78 | 22 |
| Cciiv4 vacc abx free im CPT 90756 | $5.67 | $81.00 | $31.94 – $97.20 | 13 |
| Cciiv4 vac no prsv 0.5 ml im CPT 90674 | $14.91 | $213.00 | $11.24 – $234.30 | 14 |
| Cdna analysis for variants CPT 81403 | $38.50 | $550.00 | $150.00 – $1,575.52 | 23 |
| Cdp-sot 6 cond w/i&r CPT 92548 | $5.74 | $82.00 | $30.07 – $350.97 | 36 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $14.11 | $201.60 | $0.80 – $136.88 | 19 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $35.33 | $504.68 | $1.96 – $449.30 | 10 |
| Cefotaxime sodium injection HCPCS J0698 | $22.02 | $314.63 | $5.95 – $449.61 | 11 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $23.88 | $341.10 | $9.03 – $310.19 | 11 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $326.56 | $4,665.18 | $0.47 – $16.01 | 23 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $18.65 | $266.49 | $3.31 – $228.64 | 10 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $11.20 | $160.00 | $0.43 – $7.69 | 19 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $13.68 | $195.36 | $3.52 – $279.17 | 10 |
| #celiac hla-dq8 CPT 81383 | $6.79 | $97.01 | $97.01 – $551.58 | 23 |
| Cell count body fluid CPT 89050 | $45.99 | $657.00 | $4.72 – $52.04 | 24 |
| Cell count w differential body fluid CPT 89051 | $45.57 | $651.00 | $4.86 – $60.63 | 24 |
| Cell enumeration & id CPT 86152 | $19.69 | $281.31 | $250.78 – $2,184.59 | 22 |
| Cell function assay w/stim CPT 86352 | $9.51 | $135.86 | $135.86 – $745.82 | 22 |
| Cell marker study CPT 88182 | $6.16 | $87.98 | $68.73 – $230.40 | 24 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | $87.15 | $1,245.00 | $60.80 – $610.42 | 34 |
| Cervical collar molded to pt HCPCS L0170 | $84.07 | $1,201.00 | $513.13 – $1,959.48 | 17 |
| Cervical laminoplsty 2/> seg CPT 63050 | $350.70 | $5,010.00 | $764.70 – $3,541.26 | 34 |
| Cervical lymphadenectomy 38720 CPT 38720 | $321.72 | $4,596.00 | $801.19 – $2,628.10 | 34 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | $9.10 | $130.00 | $9.48 – $267.99 | 34 |
| Cesarean section delivery only 59514 CPT 59514 | $205.52 | $2,936.00 | $60.00 – $2,115.57 | 34 |
| #cf-97variants CPT 81220 | $38.96 | $556.60 | $247.86 – $4,462.94 | 23 |
| Cftr gene dup/delet variants CPT 81222 | $30.45 | $435.07 | $435.07 – $1,062.76 | 23 |
| Change cystostomy tube; complex 51710 CPT 51710 | $19.25 | $275.00 | $73.51 – $1,839.42 | 36 |
| Change cystostomy tube simple CPT 51705 | $24.29 | $347.00 | $47.05 – $304.00 | 36 |
| Change g-tube to g-j perc CPT 49446 | $655.55 | $9,365.00 | $40.00 – $5,061.94 | 36 |
| Change nephroureteral cath CPT 50387 | $664.65 | $9,495.00 | $621.85 – $5,514.28 | 18 |
| Change of ureter tube/stent CPT 50688 | $19.04 | $272.00 | $60.00 – $144.68 | 34 |
| Change of windpipe airway 31502 CPT 31502 | $28.07 | $401.00 | $30.00 – $304.00 | 36 |
| Change stent via transureth CPT 50385 | $701.26 | $10,018.00 | $187.42 – $5,514.28 | 36 |
| Change ureter stent percut CPT 50382 | $851.27 | $12,161.00 | $1,362.99 – $5,514.28 | 18 |
| Chemical exfoliation acne 17360 CPT 17360 | $30.52 | $436.00 | $51.01 – $304.00 | 18 |
| Chemical peel nonfacial 15793 CPT 15793 | $119.63 | $1,709.00 | $123.23 – $304.00 | 18 |
| Chemical peel nonfacial; epidermal CPT 15792 | $84.63 | $1,209.00 | $114.81 – $304.00 | 18 |
| Chemo adm cns w/lmbr punct CPT 96450 | $13.02 | $186.00 | $66.19 – $871.32 | 36 |
| Chemodener muscle larynx emg CPT 64617 | $39.55 | $565.00 | $90.93 – $440.47 | 36 |
| Chemodenerv 1 extrem 1-4 ea 64643 CPT 64643 | $22.61 | $323.00 | $15.00 – $203.61 | 36 |
| Chemodenerv 1 extrem 5/> ea 64645 CPT 64645 | $29.19 | $417.00 | $15.00 – $249.32 | 36 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | $79.94 | $1,142.00 | $60.68 – $359.44 | 36 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $79.94 | $1,142.00 | $15.00 – $311.66 | 36 |
| Chemodenervation anal musc CPT 46505 | $61.04 | $872.00 | $189.13 – $3,156.66 | 36 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $33.81 | $483.00 | $83.40 – $304.00 | 36 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | $52.57 | $751.00 | $70.00 – $837.29 | 36 |
| Chemodenerv eccrine glands CPT 64653 | $25.34 | $362.00 | $58.45 – $304.00 | 18 |
| Chemodenerv eccrine glands 64650 CPT 64650 | $21.84 | $312.00 | $51.01 – $304.00 | 18 |
| Chemodenerv musc migraine 64615 CPT 64615 | $36.05 | $515.00 | $45.00 – $311.66 | 36 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $51.10 | $730.00 | $90.47 – $304.00 | 36 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | $27.44 | $392.00 | $86.00 – $809.72 | 36 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | $79.94 | $1,142.00 | $20.00 – $336.59 | 36 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $79.94 | $1,142.00 | $45.00 – $388.53 | 36 |
| Chest 2 vws w oblique CPT 71048 | $4.06 | $58.00 | $14.94 – $48.70 | 34 |
| Chest apical lordotic proj CPT 71047 | $119.00 | $1,700.00 | $13.04 – $279.75 | 37 |
| Chest CT scan (with and without contrast) CPT 71270 | $770.00 | $11,000.00 | $36.11 – $2,474.55 | 37 |
| Chest CT scan (with contrast) CPT 71260 | $704.97 | $10,071.00 | $32.65 – $1,985.26 | 37 |
| Chest CT scan (without contrast) CPT 71250 | $612.99 | $8,757.00 | $26.76 – $1,659.94 | 37 |
| Chest X-ray CPT 71046 | $108.22 | $1,546.00 | $10.24 – $229.57 | 37 |
| Chest X-ray (single view) CPT 71045 | $82.60 | $1,180.00 | $8.49 – $229.57 | 37 |
| Chg pr pul rehab for copd patients CPT 94626 | $39.06 | $558.00 | $67.14 – $210.00 | 20 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $9.10 | $130.00 | $32.60 – $119.23 | 34 |
| Chimerism anal no cell selec CPT 81267 | $14.52 | $207.46 | $164.94 – $5,768.92 | 23 |
| Chimerism anal w/cell select CPT 81268 | $18.26 | $260.79 | $164.94 – $2,710.50 | 23 |
| Chiropractic manj 5 regions CPT 98942 | $9.10 | $130.00 | $23.02 – $304.00 | 18 |
| Chiropract manj 1-2 regions CPT 98940 | $4.83 | $69.00 | $23.02 – $304.00 | 18 |
| Chiropract manj 3-4 regions CPT 98941 | $7.00 | $100.00 | $23.02 – $304.00 | 18 |
| Chlamydia culture CPT 87110 | $1.18 | $16.87 | $5.30 – $215.49 | 23 |
| Chlamydia type CPT 87140 | $0.39 | $5.57 | $1.68 – $61.37 | 23 |
| Chlnggrphy intraop addl s&i CPT 74301 | $55.93 | $799.00 | $9.54 – $193.74 | 35 |
| Chloride CPT 82435 | $40.74 | $582.00 | $1.46 – $51.00 | 23 |
| Chloride 24 hour urine CPT 82436 | $7.70 | $110.00 | $1.46 – $55.22 | 23 |
| Chloroprocaine hcl injection HCPCS J2401 | $39.20 | $559.95 | $0.04 – $800.17 | 10 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $208.10 | $2,972.90 | $5.15 – $4,248.27 | 11 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $50.60 | $722.79 | $0.01 – $1,032.87 | 11 |
| Cholangiogram percutaneous compl CPT 47532 | $626.50 | $8,950.00 | $8.00 – $9,444.82 | 36 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $248.08 | $3,544.00 | $13.03 – $75.60 | 34 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | $264.11 | $3,773.00 | $35.00 – $2,057.34 | 36 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $1,406.93 | $20,099.00 | $305.50 – $9,444.82 | 36 |
| Cholesterol CPT 82465 | $44.24 | $632.00 | $1.12 – $47.82 | 23 |
| Cholesterol body fluid CPT 84999 | $52.99 | $757.00 | $7.96 – $14.33 | 6 |
| Cholesterol (Lipid) Test CPT 80061 | $45.64 | $652.00 | $3.83 – $147.24 | 23 |
| Cholinesterase CPT 82480 | $0.55 | $7.87 | $2.82 – $86.61 | 23 |
| Chrom analysis CPT 88273 | $11.21 | $160.13 | $34.81 – $2,089.34 | 24 |
| Chromatography CPT 83021 | $2.02 | $28.80 | $6.71 – $197.73 | 23 |
| Chromogenic substrate assay CPT 85130 | $9.87 | $141.00 | $4.32 – $129.77 | 23 |
| Chromo high res and frag x - sendout CPT 81243 | $3.99 | $57.04 | $45.63 – $515.23 | 23 |
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.