lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
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 |
|---|---|---|---|---|
| Above knee flex cover system HCPCS L5964 | not published | not published | $891.96 – $1,032.79 | 7 |
| Above knee leather socket HCPCS L5642 | not published | not published | $443.56 – $513.60 | 7 |
| Above knee manual lock HCPCS L5925 | not published | not published | $1,127.55 – $1,305.58 | 7 |
| Above knee wood socket HCPCS L5644 | not published | not published | $443.56 – $513.60 | 7 |
| Abrasion lesions add-on CPT 15787 | not published | not published | $224.79 – $260.28 | 7 |
| Abrasion lesion single CPT 15786 | not published | not published | $198.70 – $260.28 | 7 |
| Abscess drain retroperitoneal surg code CPT 49406 | not published | not published | $615.12 – $712.24 | 7 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $22.59 – $26.16 | 7 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | not published | not published | $22.59 – $26.16 | 7 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $22.59 – $26.16 | 7 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | not published | not published | $22.59 – $26.16 | 7 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $22.59 – $26.16 | 7 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | not published | not published | $13,911.07 – $16,107.55 | 7 |
| Access thoracic lymph duct CPT 38794 | not published | not published | $476.40 – $551.62 | 7 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $0.20 | $0.30 | $0.08 – $14.86 | 30 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | not published | not published | $22.59 – $26.16 | 7 |
| Acetaminophen level CPT 80143 | $83.85 | $129.00 | $7.78 – $116.10 | 30 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $102.86 | $158.25 | $44.75 – $142.43 | 30 |
| Acetone qualitative CPT 82009 | $20.15 | $31.00 | $2.33 – $27.90 | 30 |
| Acetylcholine receptor modulating antibody CPT 86043 | $53.95 | $83.00 | $5.03 – $74.70 | 30 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $5.76 – $27.98 | 7 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $3.90 | $6.00 | $1.70 – $14.86 | 30 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $12.83 – $16.15 | 8 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $381.24 – $461.73 | 7 |
| Acne surgery 10040 CPT 10040 | not published | not published | $198.70 – $260.28 | 7 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $91.53 – $206.14 | 8 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $91.53 – $160.69 | 8 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | not published | not published | $92.50 – $103.79 | 2 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | not published | not published | $160.67 – $181.34 | 2 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | not published | not published | $115.40 – $133.62 | 7 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $77.35 | $119.00 | $0.01 – $107.10 | 30 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $65.00 | $100.00 | $16.62 – $128.35 | 30 |
| Acoustic immitance testing CPT 92570 | not published | not published | $131.46 – $207.60 | 7 |
| Acoustic refl threshold tst CPT 92568 | $102.05 | $157.00 | $38.16 – $141.30 | 30 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $3,244.61 – $5,050.72 | 7 |
| Acth stimulation panel CPT 80402 | not published | not published | $36.88 – $42.70 | 7 |
| Acth stimulation panel CPT 80406 | not published | not published | $36.88 – $42.70 | 7 |
| Actigraphy testing CPT 95803 | not published | not published | $59.40 – $133.62 | 7 |
| Actinotherapy uv light CPT 96900 | not published | not published | $38.16 – $47.96 | 7 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $24.49 – $47.96 | 7 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | not published | not published | $41.42 – $47.96 | 7 |
| Acup 1/> without estim ea add 15 CPT 97811 | not published | not published | $41.42 – $47.96 | 7 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $24.49 – $47.96 | 7 |
| Acute hepatitis panel CPT 80074 | $213.85 | $329.00 | $24.53 – $296.10 | 30 |
| Acute venous thrombus image CPT 78456 | not published | not published | $414.66 – $480.13 | 7 |
| Acyclovir 400 mg tablet HCPCS J8499 | not published | not published | $69.50 – $80.48 | 7 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $3.59 | $5.52 | $1.36 – $14.86 | 30 |
| #acylcarnitineprfl CPT 82017 | $75.40 | $116.00 | $8.69 – $104.40 | 30 |
| Acylcarnitines qual CPT 82016 | not published | not published | $7.14 – $27.98 | 7 |
| Adalimumab injection HCPCS J0135 | not published | not published | $1,794.07 – $2,077.34 | 7 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $160.67 – $280.64 | 7 |
| Adapter b 8 channel 10cm HCPCS C1883 | not published | not published | $267.61 – $309.86 | 7 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $92.50 – $280.64 | 7 |
| Adding walker to prev cast CPT 29440 | not published | not published | $140.23 – $162.37 | 7 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $1,127.55 – $1,305.58 | 7 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $77.94 – $90.24 | 7 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $443.56 – $513.60 | 7 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $121.57 – $140.77 | 7 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $121.57 – $140.77 | 7 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $121.57 – $140.77 | 7 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $1,715.53 – $1,986.40 | 7 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $1,127.55 – $1,305.58 | 7 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $443.56 – $513.60 | 7 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $18.72 | $28.80 | $2.55 – $80.48 | 30 |
| Adenovirus ag ia CPT 87301 | $53.95 | $83.00 | $6.17 – $74.70 | 30 |
| Adenovirus antibody,serum - quest CPT 86603 | $57.85 | $89.00 | $6.63 – $80.10 | 30 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $21.76 – $25.66 | 7 |
| Adenovirus vaccine type 4 CPT 90476 | not published | not published | $13.31 – $15.41 | 7 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $3,709.90 – $4,295.68 | 7 |
| Adhesive, liquid or equal HCPCS A4364 | not published | not published | $22.59 – $26.16 | 7 |
| Adh-sendout CPT 84588 | $152.10 | $234.00 | $17.48 – $210.60 | 30 |
| Adj gastric band via subq port CPT 43999 | not published | not published | $926.63 – $4,640.80 | 7 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $2,200.29 – $2,547.70 | 7 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $1,829.23 – $2,265.43 | 7 |
| Adjustment gastric band HCPCS S2083 | not published | not published | $540.20 – $625.49 | 7 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $223.94 | $344.52 | $0.36 – $14.86 | 30 |
| Admin ecg contrast agent CPT 93352 | not published | not published | $470.59 – $544.90 | 7 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $319.15 | $491.00 | $71.17 – $602.97 | 30 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | not published | not published | $71.17 – $428.04 | 7 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $1,487.85 | $2,289.00 | $331.69 – $2,060.10 | 30 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $60.66 – $70.24 | 7 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $319.15 | $491.00 | $60.66 – $441.90 | 30 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | not published | not published | $60.66 – $70.24 | 7 |
| Administration immunization each additional component CPT 90461 | $17.55 | $27.00 | $7.64 – $26.35 | 30 |
| Administration immunization each additional vaccine CPT 90472 | $41.60 | $64.00 | $18.10 – $57.60 | 30 |
| Administration immunization first component each vaccine CPT 90460 | $45.50 | $70.00 | $6.01 – $26.35 | 30 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $139.10 | $214.00 | $22.75 – $192.60 | 30 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $22.75 – $26.35 | 7 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $102.70 | $158.00 | $6.01 – $26.35 | 30 |
| Administration vaccine hepatitis b HCPCS G0010 | not published | not published | $22.75 – $26.35 | 7 |
| Administration vaccine influenza virus HCPCS G0008 | $120.25 | $185.00 | $22.75 – $166.50 | 30 |
| Administration vaccine pneumococcal HCPCS G0009 | not published | not published | $22.75 – $26.35 | 7 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $102.70 | $158.00 | $22.75 – $142.20 | 30 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $19,916.21 | $30,640.32 | $40.45 – $17,235.22 | 30 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $1,183.57 – $1,370.45 | 7 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $2,703.49 – $3,130.36 | 7 |
| Adrenalin epinephrine inject HCPCS J0171 | $712.08 | $1,095.51 | $12.83 – $486.00 | 30 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $29.11 – $33.70 | 7 |
| Adv prim care mgmt lvl 1 HCPCS G0556 | not published | not published | $29.79 – $38.28 | 2 |
| Adv prim care mgmt lvl 2 HCPCS G0557 | not published | not published | $29.79 – $38.28 | 2 |
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.